IndividualActive
Jessie Brunelle, LCSW
NPI 1306351317 · Social Worker · Wanship, UT
Provider details
- NPI number
- 1306351317
- Entity type
- Individual
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1605 Navajo Rd
Wanship, UT 84017-6241
Phone: (208) 407-0588
Approximate (ZIP-level) locationGet directions
Mailing address
1605 Navajo Rd
Wanship, UT 84017-7047
Additional practice locations (1)
- 190 E Bannock StBoise, ID 83712-6241Phone: (208) 381-2616
Registry dates
- Enumerated
- 2017-12-13
- Last updated
- 2022-10-17
- Certified
- 2022-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.