Landry L Pebler, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

16938 Issued in AZ

Practice address

2345 S Alma School Rd Ste 105
Mesa, AZ 85210-4013

Phone

(480) 442-7706

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Landry Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 20, 2024 through Mar 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1104380385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 E GEMINI DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833253",
            "telephone_number": "480-766-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 S ALMA SCHOOL RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104013",
            "telephone_number": "480-442-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEBLER",
        "first_name": "LANDRY",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "16938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANDRY",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kerry Karl Pearson, O.D.
• Loreen Pearson
• Patience Pearson, LMSW
• Erik Pease, DMD
• Ronda Peasel
• Leslie A. Pechkurow, PC
• Svetlana Pedenko, M.D.
• Amber Pedersen
• Kailey M Pedersen, MT-BC
• Alexis Marie Pederson

• Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.