Candace Danielle Benford, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Saint Louis, MO
NPI 1679205140 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1679205140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2022034853 (MO)
- Practice address
- 3009 N Ballas Rd
Dept Psychiatry, Ste 141a
Saint Louis, MO 63131-2322 - Phone
- (314) 286-1700
- Fax
- (314) 627-7225
- NPI assigned
- Jun 24, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SSM Health Care St Louis
Lifetime Psychiatry LLC
Washington University
Practice addresses (Care Compare)
12355 De Paul Dr
Suite 150
Bridgeton, MO 63044-2581
Phone (314) 344-7200
5700 Mexico Rd
Suite 8
Saint Peters, MO 63376-1667
Phone (636) 477-6464
600 S Taylor Ave
Suite 122
Saint Louis, MO 63110-1035
Phone (314) 286-1700
Hospital & facility affiliations
- SSM St Joseph Health Center
- SSM Health Depaul Hospital St Louis
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221007002695 | MO | Practitioner - Nurse Practitioner | 9436535895 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022034853 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Cardinal Glennon Childrens Hospital | Current |
Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Current |
Accepting new patients | |
| Lifetime Psychiatry LLC | Current |
Accepting new patients | |
| SSM Health Care St. Louis | Current |
Accepting new patients | |
| SSM Health Care St Louis | Current |
Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
12355 De Paul Dr
Ste 150
Bridgeton, MO 63044
Phone (314) 344-7153
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
3800 Park Ave
Saint Louis, MO 63110
Phone (314) 577-5600
5700 Mexico Rd
Ste 8
Saint Peters, MO 63376
Phone (636) 477-6464
Interoperability endpoints
- cbenford4254@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2022034853 | MO | Yes |
Addresses
Primary practice location
3009 N Ballas Rd
Dept Psychiatry, Ste 141a
Saint Louis, MO 63131-2322
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420115486 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Other providers in Saint Louis, MO
- Danielle R Benematti
- Benemed Diagnostics LLC
- Katie Lynn Benenati
- Blake Beneville
- Benevolent Home Health Care LLC
- Kiera Margaret Benge-Shea
- Bryan Bengston
- Derek Alan Benham
- Dirk A. Benham
- Amber Christine Benhardt
All providers in Saint Louis, MO · Psychiatric/Mental Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.