Provider Demographics
NPI:1497506687
Name:PAT J BRUNO DBA THREE STRANDS MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:PAT J BRUNO DBA THREE STRANDS MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-827-8136
Mailing Address - Street 1:105 RHONDA LN
Mailing Address - Street 2:
Mailing Address - City:ROSE BUD
Mailing Address - State:AR
Mailing Address - Zip Code:72137-8003
Mailing Address - Country:US
Mailing Address - Phone:501-827-8134
Mailing Address - Fax:479-763-0105
Practice Address - Street 1:105 RHONDA LN
Practice Address - Street 2:
Practice Address - City:ROSE BUD
Practice Address - State:AR
Practice Address - Zip Code:72137-8003
Practice Address - Country:US
Practice Address - Phone:501-827-8134
Practice Address - Fax:479-763-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR324450719Medicaid
AR9685COtherARKANSAS SOCIAL WORK LICENSING BOARD