Sally V Benner, MA LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0000606 Issued in OH

Practice address

1195 Meadow Bridge Dr Ste B
Beavercreek, OH 45434-4302

Phone

(937) 426-2079

Fax

(937) 426-0211

NPI assigned

Feb 21, 2007

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 identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dene S Berman Lifespan Counseling Associates

  • Mental Health Counselor
  • Beavercreek, OH
  • NPI 1407991862
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1871638353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340398",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454340398",
            "telephone_number": "937-426-2079",
            "fax_number": "937-426-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 MEADOW BRIDGE DR STE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454344302",
            "telephone_number": "937-426-2079",
            "fax_number": "937-426-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "SALLY",
        "middle_name": "V",
        "credential": "MA LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0000606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000212111",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "14842215002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "338149",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "02099000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory David Bellanca, NP
• Allison Bellar, PHARMD
• Robert John Belloto Jr., R.PH., PH.D.
• Nicole Louise Belvo
• Lauryn Bender, RBT
• Barbara A Bennett, D.O.
• Sonia Ibuki Bennett, MD
• Timothy Robert Bennett, DO
• Kristopher Benson, RBT
• Tyler Berger

• Mental Health Counselor in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.