KYLE W BRUCKE (LICSW) – Clinical Social Worker, NPI 1174146195

KYLE W BRUCKE (LICSW) is a healthcare provider. based in Jasper, Alabama. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 4294C (AL). The NPI Number for KYLE W BRUCKE (LICSW) is 1174146195

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
KYLE W BRUCKE (LICSW)
NPI
1174146195
Phone
Not provided
Address
1100 7TH AVE
Enumeration Date
26 May 2020
Last Update Date
16 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2562883333
Graduation Year
2016 (10 years ago)
PAC ID
9830590942
Group Practice PAC ID
7416194113
Professional Enrollment ID
I20210628000926
Address ID
AL356031026DE1615XSWXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

390 CLINICAL SOCIAL WORKER in AL

Provider Addresses for KYLE W BRUCKE (LICSW)

  • 1100 7TH AVE

    JASPER, AL 355014377

    Phone:

    Type: Mailing

  • 600 SUN TEMPLE DR

    MADISON, AL 357588643

    Phone: (256) 288-3333

    Fax: (256) 288-3334

    Type: Mailing

  • 1965 AL HIGHWAY 157 STE B

    CULLMAN, AL 350580672

    Phone: (256) 701-5651

    Fax: (256) 429-9411

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-06-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210628000926IClinical Social WorkerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour3514$0
View full utilization report →

Insurance plans in this area (ZIP 35501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416194113View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm KYLE W BRUCKE (LICSW)'s NPI?
Yes. KYLE W BRUCKE (LICSW) is listed with NPI 1174146195 in the public NPI dataset.
Can I rely on KYLE W BRUCKE (LICSW) being an active provider?
As of the registry snapshot, KYLE W BRUCKE (LICSW) is marked active.
What is KYLE W BRUCKE (LICSW)'s specialty?
The listing groups KYLE W BRUCKE (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What area does KYLE W BRUCKE (LICSW) serve?
KYLE W BRUCKE (LICSW)'s listing highlights Jasper, Alabama; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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