BENTON STREET COUNSELING LLC (NPI# 1932597721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932597721 |
| Entity Type | Organization |
| Organization Name | BENTON STREET COUNSELING LLC |
| Practice Address |
119 N Benton St Waynesville MO 65583-2501 |
| Practice Telephone | 5734332833 |
| Practice Fax Number | 5734332829 |
| Mailing Telephone | 5734332833 |
| Mailing Fax Number | 5734332829 |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2017-04-13 |
| Authorized Official Name | MARY ANN WYATT (MEMBER) |
| Authorized Official Telephone | 5734332833 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
2012036248 | MO | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
2013015853 | MO | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1932597721 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578053955 | Benton Street Counseling LLC | Social Worker | 1030 Kingshighway St Ste A, Rolla, MO 65401-2930 | 2018-05-11 |
| 1891229878 | Benton Street Counseling LLC | Counselor | 89 Mccrory Drive, Camdenton, MO 65020 | 2017-04-17 |
| Street Address |
119 N BENTON ST |
| City | WAYNESVILLE |
| State | MO |
| Zip Code | 65583-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366401408 | Amy E Kersten | Social Worker | 119 N Benton St, Waynesville, MO 65583-2501 | 2006-03-18 |
| 1013560234 | Zodie L Flemings | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2019-07-17 |
| 1891264164 | Maegan Bridges | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2018-11-16 |
| 1679010086 | Rebecca Ann Williams | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2017-01-23 |
| 1194173104 | Michelle Glenda Boatman | Marriage & Family Therapist | 119 N Benton St, Waynesville, MO 65583-2501 | 2016-05-31 |
| 1639535818 | Richelle Wisdom | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2016-01-04 |
| 1417338575 | Malinda Williams | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2015-06-15 |
| 1922486646 | Kayla Bell | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2015-05-14 |
| 1912316985 | Shannon L O'connell | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2014-08-04 |
| 1710252333 | Mary Ann Wyatt | Counselor | 119 N Benton St, Waynesville, MO 65583-2501 | 2012-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972133460 | Fnp4jc, LLC | Family Medicine | 215 North Street, Waynesville, MO 65583 | 2020-01-23 |
| 1134770464 | Patricia Harper | Technician | 25455 Hwy W, Waynesville, MO 65583 | 2019-09-27 |
| 1619430519 | Charles L Quinn | Counselor | Hope Connections LLC 704 Historic Rte. 66w Suite 101, Waynesville, MO 65583 | 2019-04-09 |
| 1801340609 | Nicole Marie Decher | Social Worker | 704 Historic 66 W # 207, Waynesville, MO 65583 | 2016-08-09 |
| 1780952945 | Joseph Benton Isaac | Dentist | 1400 State Rd F, Reznicek Dental Group LLC, Waynesville, MO 65583 | 2011-12-02 |
| 1326325192 | Paul Duane Reznicek | Dentist | 1400 State Rt F, Waynesville, MO 65583 | 2011-11-08 |
| 1629366182 | Bletel Residential Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18844 Ladera Ln, Waynesville, MO 65583 | 2011-07-19 |
| 1720218126 | Pulaski County Board for The Handicapped | Case Management | 301 Historic Route 66 East, Waynesville, MO 65583 | 2009-07-20 |
| 1447436001 | Joseph Garold Moody | Counselor | 1000 Hospital Road., Piney Ridge Center, Waynesville, MO 65583 | 2008-01-14 |
| 1841404746 | Valencia Sivells | Counselor | 411 Historic Rte 66 West, Waynesville, MO 65583 | 2007-05-09 |
| Find all providers in zip 65583 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225656622 | Heather Nicole Conner | Counselor | 24 Trinity Pl, Waynesville, NC 28786-6196 | 2020-07-12 |
| 1861911034 | Daniel Yearick, Lpc, Ncc - Adult & Adolescent Psychotherapy, LLC | Counselor | 166 Branner Ave Ste B, Waynesville, NC 28786-3244 | 2017-09-19 |
| 1720523434 | Ashley Wildrick | Counselor | 704 Historic 66 W, Suite 207, Waynesville, MO 65583-2136 | 2017-01-04 |
| 1215481320 | Gregory Dunmore | Counselor | 704 Route 66 W, 207, Waynesville, MO 65583-2136 | 2016-08-05 |
| 1790151918 | Erin Cooke | Counselor | 367 Dellwood Rd Ste A2, Waynesville, NC 28786-3136 | 2015-08-12 |
| 1861767105 | Geralyn Hartley | Counselor | 309 Skyline Dr, Waynesville, MO 65583-2132 | 2012-03-20 |
| 1720317803 | Barbara S. Bryans-brennan | Counselor | 56 Montgomery Street, Ste D, Waynesville, NC 28786-7313 | 2009-12-18 |
| 1114187861 | Michelle E. Higgins | Counselor | 20 Hodges Dr, Waynesville, NC 28786-5791 | 2008-06-16 |
| 1447436001 | Joseph Garold Moody | Counselor | 1000 Hospital Road., Piney Ridge Center, Waynesville, MO 65583 | 2008-01-14 |
| 1336205921 | Catherine Quick Harlan | Counselor | 1207 East Street, Waynesville, NC 28786 | 2006-12-28 |
| Find all providers in WAYNESVILLE | ||||
| City | WAYNESVILLE |
| Zip Code | 65583 |
Please comment or provide details below to improve the information on BENTON STREET COUNSELING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.