Vine Behavioral Health LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

VINE BEHAVIORAL HEALTH LLC

Practice address

2716 Revere Ave
Dayton, OH 45420-1722

Phone

(937) 751-6763

NPI assigned

Jul 31, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erika Russ, M.S.

Title

Co-Founder

Phone

(937) 751-6763

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1215618202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 REVERE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201722",
            "telephone_number": "937-751-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 REVERE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201722",
            "telephone_number": "937-751-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "RUSS",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "937-751-6763",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea D Vincent, MBA, BSN, RN
• Kathryn Vincent
• Kyle Vincent, M.D.
• Portia Vincent, C-FNP
• Andrew Michael Vincze, OD
• Vinod K Patwa MD Inc
• Sarina Vinson, LPN
• Audrey Violand, MSSW LSW
• Nick Ayden Violet
• Jessica Vires, CDCA

• Behavior Analyst in Dayton, OH
• Providers in Dayton, OH by specialty
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.