Branch & Vine LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BRANCH & VINE LLC

Practice address

2040 W Main St
Ste 311
Rapid City, SD 57702

Phone

(605) 600-3733

NPI assigned

Mar 26, 2022

Organization subpart

No

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

Authorized official

Name

Edmund Jason Stamper, LPC-MH, NCC, QMHPNPI 1790158558

Title

Founder Member

Phone

(605) 600-3733

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edmund Jason Stamper, LPC-MH, QMHP, NCC

  • Mental Health Counselor
  • Rapid City, SD
  • NPI 1790158558
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648252800000",
    "number": "1326798943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST",
            "address_2": "STE 311",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-600-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST",
            "address_2": "STE 311",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-600-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH & VINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A",
        "authorized_official_last_name": "STAMPER",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "FOUNDER MEMBER",
        "authorized_official_telephone_number": "605-600-3733",
        "authorized_official_credential": "LPC-MH, NCC, QMHP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Bradley, BS
• Shari Lynn Bradstream, CCDC III
• Danielle Rose Brady, NCC, LPC
• Brain Health Salon LLC
• Sharron K Bramblee, CNP PAC
• Sarah Brancheau
• Rene M Brand, MNT
• Kristin Brandis, RN
• Cassandra Brandsted, NP
• Kelly S Brandsted, CNP

• Mental Health Counselor in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Mental Health Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.