Active NPI
Crystal Benner
- Mental Health Counselor
- Pittsboro, IN
National Provider Identifier
1861215451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39005174A
- Practice address
- 5565 N County Road 100 E
Pittsboro, IN 46167-9433 - Phone
- (317) 512-4105
- NPI assigned
- Nov 4, 2024
- Last updated
- Nov 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39005174A | IN | Primary |
Addresses
Primary practice location
5565 N County Road 100 E
Pittsboro, IN 46167-9433
Mailing address
4845 Bulldog Way
Brownsburg, IN 46112-1466
Phone (317) 852-1060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39005174A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1861215451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4845 BULLDOG WAY",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121466",
"telephone_number": "317-852-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5565 N COUNTY ROAD 100 E",
"city": "PITTSBORO",
"state": "IN",
"postal_code": "461679433",
"telephone_number": "317-512-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNER",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39005174A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsboro, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.