Provider Demographics
NPI:1316161284
Name:BRUMMETT, JAMES HAROLD WILBUR (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HAROLD WILBUR
Last Name:BRUMMETT
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 N MITCHNER AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3825
Mailing Address - Country:US
Mailing Address - Phone:317-375-0472
Mailing Address - Fax:
Practice Address - Street 1:6002 E 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5614
Practice Address - Country:US
Practice Address - Phone:317-880-6002
Practice Address - Fax:317-880-0417
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004547A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical