| Visionary Mental Health Services, Llc | |
|
1709 N Lincoln Ave Ste 102 Pierre SD 57501-7808 | |
| (605) 280-9778 | |
| (605) 385-0045 |
| Full Name | Visionary Mental Health Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1709 N Lincoln Ave Ste 102, Pierre, South Dakota |
| Authorized Official Name and Position | Lindsay Leigh Bruckner (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6052809778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visionary Mental Health Services, Llc 1709 N Lincoln Ave Ste 102 Pierre SD 57501-7808 Ph: (605) 280-9778 | Visionary Mental Health Services, Llc 1709 N Lincoln Ave Ste 102 Pierre SD 57501-7808 Ph: (605) 280-9778 |
| NPI Number | 1912423500 |
|---|---|
| Provider Enumeration Date | 08/16/2017 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/06/2023 |
| Medicare PECOS PAC ID | 8426393950 |
|---|---|
| Medicare Enrollment ID | O20190102002058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912423500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 3598 (South Dakota) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Lindsay L Bruckner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568917243 PECOS PAC ID: 8325383847 Enrollment ID: I20190102001705 |
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