Shawn Thomas Benningfield, LPCC
Individual provider Active NPI Professional Counselor · Louisville, KY
NPI 1033468525 · NPPES record last updated Jun 6, 2018
Key facts
- NPI
- 1033468525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 165330 (KY)
- Practice address
- 9702 Stonestreet Rd Ste 120
Louisville, KY 40272 - Phone
- (502) 749-6249
- NPI assigned
- Aug 30, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240426001521 | KY | Practitioner - Mental Health Counselor | 1557701356 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Astra Behavioral Health LLC | Current |
Accepting new patients |
Locations
1013 Granite Dr
Bardstown, KY 40004
Phone (270) 506-2730
2000 Ring Rd
Elizabethtown, KY 42701
Phone (270) 506-2730
420 N Loretto Rd
Ste 200
Lebanon, KY 40033
Phone 2703214480 ext. 306
4010 DuPont Cir
Ste 210
Louisville, KY 40207
Phone (502) 694-4820
162 S Buckman St
Shepherdsville, KY 40165
Phone (502) 215-8770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | 165330 | KY | Yes |
Addresses
Primary practice location
9702 Stonestreet Rd Ste 120
Louisville, KY 40272
Mailing address
9702 Stonestreet Rd Ste 120
Louisville, KY 40272-6812
Phone (502) 749-6249
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100527100 | Medicaid | KY |
Other providers in Louisville, KY
- Tina Clinton Bennett
- Christina K Benninger
- Thomas W Benninger
- Bridget Lynn Benningfield
- Brittney Ann Benningfield
- Steffany Bennington
- Matthew V. Benns
- Jordan Benock
- Lincy Benoy
- Charles Brook Bensenhaver III
All providers in Louisville, KY · Professional Counselor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.