Petsburgh Therapy Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PETSBURGH THERAPY SERVICES LLC

Doing business as

Candace D Benner

Practice address

19871 Sackett LN
Waynesville, MO 65583-3510

Phone

(573) 315-3848

Fax

(573) 312-3848

NPI assigned

Apr 9, 2021

Last updated

Mar 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Candace D Benner, MA, LPC, CCTP, EMDRNPI 1467869156

Title

Owner/Trauma Specialist

Phone

(573) 315-3848

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Candace D Benner Doing business as

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Candace D Benner, MA, LPC, CCTP, EMDR

  • Mental Health Counselor
  • Waynesville, MO
  • NPI 1467869156
  NPD Authorized official
• Susan Alejandra Thompson, CIT

  • Mental Health Counselor
  • Waynesville, MO
  • NPI 1922849413
  NPD

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1518547918",
    "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": "573-315-3448",
            "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": {
        "organization_name": "PETSBURGH THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "BENNER",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/TRAUMA SPECIALIST",
        "authorized_official_telephone_number": "573-315-3848",
        "authorized_official_credential": "MA, LPC, CCTP, EMDR"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467869156",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@petsburghtherapy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "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": [
        {
            "organization_name": "Candace D Benner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Padgett
• Melanie Pahuyo, RN-BSN
• Shelly Lynn Patterson, COTA
• Janina Frances Pawlak
• Neftali Perez, LPC
• Melissa Christie Petty, OTR/L
• Phelps County Regional Medical Center (Phelps Health Medical Group Waynesville)
• Johnna Pitts, 2017002215
• Tonya Powell, LPC
• Melodie Prater, LPC

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.