Candace D Benner, MA, LPC, CCTP, EMDR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2014034465 Issued in MO

Practice address

19871 Sackett LN
Waynesville, MO 65583-3510

Phone

(573) 315-3848

Fax

(573) 312-3848

NPI assigned

Jul 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Candee Simcox Other name

Electronic endpoints 1

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.

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Petsburgh Therapy Services LLC

  • Mental Health Counselor
  • Waynesville, MO
  • NPI 1518547918
  NPD Authorized official
• Benton Street Counseling LLC

  • Professional Counselor
  • Rolla, MO
  • NPI 1578053955

  Mental Health

  NPD (past)
• Benton Street Counseling LLC

  • Mental Health Counselor
  • Waynesville, MO
  • NPI 1932597721
  NPD (past)

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1467869156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "ROBY",
            "state": "MO",
            "postal_code": "655570114",
            "telephone_number": "573-315-3848",
            "fax_number": "573-312-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19871 SACKETT LN",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655833510",
            "telephone_number": "573-315-3848",
            "fax_number": "573-312-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "CANDACE",
        "middle_name": "D",
        "credential": "MA, LPC, CCTP, EMDR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2014034465",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014034465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490021314",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.petsburghtherapyservices.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19871 Sackett Ln",
            "city": "Waynesville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "655833510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CANDEE",
            "last_name": "SIMCOX",
            "credential": "CATP, CFTP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robin M Bates, LPC
• Tiffany Beall
• Maranda Leigh Beck
• Kayla Bell
• Grace Angelica Benitez, MSW
• Benton Street Counseling LLC
• Bercier Family Chiropractic, LLC
• Danielle Bercier, D.C.
• Kate Elizabeth Bildner, COTA/L
• Briana Billups, M.A., PLPC

• Mental Health Counselor in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.