JACQUELINE NICOLE BRUNELLE (LCSW) – Clinical Social Worker, NPI 1275416893

JACQUELINE NICOLE BRUNELLE (LCSW) is a healthcare provider. based in Oswego, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149.025327 (IL). The NPI Number for JACQUELINE NICOLE BRUNELLE (LCSW) is 1275416893

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE NICOLE BRUNELLE (LCSW)
NPI
1275416893
Phone
Not provided
Address
120 PIPER GLEN AVE
Enumeration Date
30 July 2025
Last Update Date
30 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8476950484
Graduation Year
2019 (7 years ago)
PAC ID
3072016658
Group Practice PAC ID
0941252423
Professional Enrollment ID
I20250910002905
Address ID
IL601236603EL1845XPLXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for JACQUELINE NICOLE BRUNELLE (LCSW)

  • 120 PIPER GLEN AVE

    OSWEGO, IL 605435641

    Phone:

    Type: Mailing

  • 1845 GRANDSTAND PL

    ELGIN, IL 601236603

    Phone: (847) 695-0484

    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: 2025-09-10

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
I20250910002905IClinical Social WorkerILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60543)

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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: 0941252423View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Clinical Social WorkerIL
Clinical Social WorkerIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
Nurse PractitionerIL
Mental Health CounselorIL
Clinical Social WorkerFL
Mental Health CounselorIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

Is there an official ID for JACQUELINE NICOLE BRUNELLE (LCSW) in U.S. healthcare records?
The official identifier for JACQUELINE NICOLE BRUNELLE (LCSW) is NPI 1275416893.
Is JACQUELINE NICOLE BRUNELLE (LCSW) still an active registrant?
JACQUELINE NICOLE BRUNELLE (LCSW) carries an active NPI according to the public dataset.
What expertise is attributed to JACQUELINE NICOLE BRUNELLE (LCSW)?
JACQUELINE NICOLE BRUNELLE (LCSW)'s specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is JACQUELINE NICOLE BRUNELLE (LCSW) located near Oswego?
JACQUELINE NICOLE BRUNELLE (LCSW) currently maps to Oswego, Illinois in this extract.
When was this NPI issued?
Enumeration for JACQUELINE NICOLE BRUNELLE (LCSW) is noted as July 30, 2025 where the registry provides it.

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