MEDICARE: VINE AND BRANCH COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790573251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINE AND BRANCH COUNSELING

Provider Business Mailing Address
First Line	:	2935 PINE LAKE RD STE D
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-6009
Country	:	US
Telephone Number	:	402-413-8841
Fax Number	:

Provider Business Practice Location Address
First Line	:	2935 PINE LAKE RD STE D
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-6009
Country	:	US
Telephone Number	:	402-413-8841
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	STEPHANI MCKEE
Credential	:	M.S. LIMHP
Telephone Number	:	402-413-8841

Provider Enumeration Date	:	04/25/2025
Last Update Date	:	04/25/2025

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