LANDRY L PEBLER LPC - NPI 1104380385

Q: What is Landry Pebler's NPI number?

The NPI number for Landry Pebler is 1104380385. It was assigned to this individual provider in the NPPES registry on January 22, 2019. The provider is also known as Landry Davis.

Q: What is Landry Pebler's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: Is Landry Pebler enrolled in Medicare?

No. Landry Pebler has opted out of Medicare through March 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Landry Pebler was last updated on October 4, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Landry L Pebler Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LANDRY L PEBLER LPC (NPI 1104380385) is an individual counselor in Mesa, Arizona, licensed in Arizona (16938) and active in the NPI registry since January 2019. She has opted out of Medicare through March 20, 2028.

NPPES Registry Identity

NPI1104380385

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameLANDRY L PEBLERCredential: LPC

Location Address2345 S ALMA SCHOOL RD STE 105Mesa, AZ 85210-4013

Mailing Address1890 E Gemini DrTempe, AZ 85283-3253 · (480) 766-8380

Phone(480) 442-7706

Sole ProprietorNo

Enumeration DateJanuary 22, 2019

Last NPPES UpdateOctober 4, 20233 updates tracked since enumeration

NPPES CertifiedOctober 4, 2023

✔ NPI 1104380385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in AZ · 16938

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2345 S ALMA SCHOOL RD STE 105, Mesa, AZ 85210

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Other Names 1

Former Name (1)Landry Davis

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Landry L Pebler Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 20, 2024 through March 20, 2028.

Opt-Out Effective DateMarch 20, 2024

Opt-Out In Effect ThroughMarch 20, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

K BAEHR AND ASSOCIATES

Marriage & Family Therapist