Edmund Jason Stamper, LPC-MH, QMHP, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-MH30513 Issued in SD

Practice address

2040 W Main St Ste 311
Rapid City, SD 57702-2447

Phone

(605) 600-3733

NPI assigned

Nov 2, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Branch & Vine LLC

  • Mental Health Counselor
  • Rapid City, SD
  • NPI 1326798943
  Medicare reassignment NPD Authorized official
• Behavior Management Systems, Inc.

  • Community/Behavioral Health Agency
  • Rapid City, SD
  • NPI 1295878122
  NPD (past)

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1790158558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST STE 311",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022447",
            "telephone_number": "605-600-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST STE 311",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022447",
            "telephone_number": "605-600-3733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 North St",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577011163",
            "country_code": "US",
            "telephone_number": "605-343-0650",
            "fax_number": "605-342-3692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMPER",
        "first_name": "EDMUND",
        "middle_name": "JASON",
        "credential": "LPC-MH, QMHP, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-02",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SD",
            "license": "LPC20325",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPC-MH30513",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC-MH30513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A Stacy, MD
• Amber Victoria Staedtler, DNP AGNP-BC
• Jordan Marie Staedtler, M.S.ED CCC-SLP
• Patrick Staedtler
• Rebecca L Stafford, PA-C
• Elizabeth Rose Stamper, CNP
• Sydney N Stanley, DO
• Joseph David Stanton, CRNA
• Melissa L Stanton, BA
• Kara K Stapert, 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 Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.