Visionary Mental Health Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

3598 Issued in SD

Legal business name

VISIONARY MENTAL HEALTH SERVICES, LLC

Practice address

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

Phone

(605) 280-9778

Fax

(605) 385-0045

NPI assigned

Aug 16, 2017

Last updated

Mar 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lindsay Leigh Bruckner, MSW, LCSWNPI 1568917243

Title

Licensed Clinical Social Worker

Phone

(605) 280-9778

Specialties & licenses 2

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, and the practitioner matching its NPPES authorized official.

• Lindsay Bruckner, CSW

  • Clinical Social Worker
  • Pierre, SD
  • NPI 1568917243
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1912423500",
    "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",
            "fax_number": "605-385-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "BRUCKNER",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "605-280-9778",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "SD",
            "license": "3598",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vilas Long Term Care Pharmacy
• Vilas Long Term Care Pharmacy
• Vilas Pharmacy
• Joseph Simon Villa, MD
• Danielle Diann Vis
• Dale E Vizcarra, MD
• Rodney T Vizcarra, MD
• Christine Kay Wagner IV, PTA
• Wal-Mart Stores, Inc. (Vision Center 30-1685)
• Ashley Waldner

• Adult Mental Health Clinic/Center in Pierre, SD
• Providers in Pierre, SD by specialty
• Adult Mental Health Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.