MEDICARE: VESTED COMPASS LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1790625176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VESTED COMPASS LLC

Provider Business Mailing Address
First Line	:	11752 HANOVER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1916
Country	:	US
Telephone Number	:	513-477-8413
Fax Number	:

Provider Business Practice Location Address
First Line	:	11752 HANOVER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1916
Country	:	US
Telephone Number	:	513-477-8413
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BRANDON CHARLES KUTCHERA
Credential	:	KUTCHERA
Telephone Number	:	513-477-8413

Provider Enumeration Date	:	03/28/2026
Last Update Date	:	03/28/2026

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