Individual provider Active NPI

Brandee Grace Bly, MS, NCC, LPC

  • Professional Counselor
  • Watertown, SD
National Provider Identifier
1740965037
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC20768 Issued in SD
Practice address
818 S Broadway Ste 109&110
Watertown, SD 57201-4861
Phone
(605) 610-6385
NPI assigned
Jun 15, 2023
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC20768 SD Primary

Addresses

Primary practice location

818 S Broadway Ste 109&110
Watertown, SD 57201-4861

Mailing address

2518 14TH Ave NE Apt 103
Watertown, SD 57201-7393
Phone (605) 610-6385

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
I20240916002848 SD Practitioner - Mental Health Counselor 3971044132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rising Hope Counseling, LLCGroup PAC ID 3274958640, 47 clinicians

Practice addresses (Care Compare)

818 S Broadway
Suite 109And110
Watertown, SD 57201-4861
Phone (605) 494-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC20768SDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Hope Counseling, LLC CurrentSince Aug 8, 2024 Accepting new patients
Rising Hope Together, Inc PastSince Jan 24, 2021 Accepting new patients

Locations

317 N Heritage Ave
Tea, SD 57064

600 4th St NE
Ste 203
Watertown, SD 57201
Phone (605) 886-4092

818 S Broadway
Ste 109110
Watertown, SD 57201
Phone (605) 610-6385

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1740965037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 14TH AVE NE APT 103",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572017393",
            "telephone_number": "605-610-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 S BROADWAY STE 109&110",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014861",
            "telephone_number": "605-610-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLY",
        "first_name": "BRANDEE",
        "middle_name": "GRACE",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPC20768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.