Individual provider Active NPI

Lindsay Bruckner, CSW

  • Clinical Social Worker
  • Pierre, SD
National Provider Identifier
1568917243
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3598 Issued in SD
Practice address
1709 N Lincoln Ave Ste 102
Pierre, SD 57501-7808
Phone
(605) 280-9778
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1709 N Lincoln Ave
Suite 102
Pierre, SD 57501-7808
Phone (605) 280-9778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102001705 SD Practitioner - Clinical Social Worker 8325383847 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3598SDMDClinical Social Worker
4878SDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Mental Health Services, LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

1709 N Lincoln Ave
Ste 102
Pierre, SD 57501
Phone (605) 280-9778

412 W Missouri Ave
Ste 8
Pierre, SD 57501
Phone (605) 280-9778

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3598 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

1709 N Lincoln Ave Ste 102
Pierre, SD 57501-7808

Mailing address

1709 N Lincoln Ave Ste 102
Pierre, SD 57501-7808
Phone (605) 280-9778

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2023.

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1568917243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 N LINCOLN AVE STE 102",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575017808",
            "telephone_number": "605-280-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 N LINCOLN AVE STE 102",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575017808",
            "telephone_number": "605-280-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "LINDSAY",
        "name_prefix": "Miss",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "3598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.