Provider Demographics
NPI:1194870964
Name:BRUNING, MONICA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:L
Last Name:BRUNING
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 1:5 BROWNHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-1502
Mailing Address - Country:US
Mailing Address - Phone:203-249-9645
Mailing Address - Fax:
Practice Address - Street 1:979 SUMMER ST
Practice Address - Street 2:SUITE #7
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5550
Practice Address - Country:US
Practice Address - Phone:203-249-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0041431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT251867OtherVALUE OPTIONS
CT800001809Medicare PIN