Provider Demographics
NPI:1104346477
Name:BRUNO, JENNIFER YVETTE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:YVETTE
Last Name:BRUNO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-6207
Mailing Address - Country:US
Mailing Address - Phone:484-221-2411
Mailing Address - Fax:
Practice Address - Street 1:3201 HIGHFIELD DR STE M
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:610-419-1536
Practice Address - Fax:800-556-4985
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0194981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical