Provider Demographics
NPI:1720704109
Name:VINE & BRANCH COUNSELING, LLC
Entity Type:Organization
Organization Name:VINE & BRANCH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LEANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSSW
Authorized Official - Phone:260-255-4385
Mailing Address - Street 1:14444 BLACK FARM DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7262
Mailing Address - Country:US
Mailing Address - Phone:260-336-0375
Mailing Address - Fax:
Practice Address - Street 1:10 S 9TH ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2630
Practice Address - Country:US
Practice Address - Phone:260-255-4385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)