Healthcare Provider Details

I. General information

NPI: 1811819436
Provider Name (Legal Business Name): BRADY UMBERGER CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 SIOUX SAN DR STE 204
RAPID CITY SD
57702-8207
US

IV. Provider business mailing address

3735 GRAND LOOP
SPEARFISH SD
57783-8044
US

V. Phone/Fax

Practice location:
  • Phone: 605-645-4873
  • Fax:
Mailing address:
  • Phone: 605-645-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7123
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: