Provider Demographics
NPI:1104380385
Name:PEBLER, LANDRY L (LPC)
Entity Type:Individual
Prefix:
First Name:LANDRY
Middle Name:L
Last Name:PEBLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LANDRY
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1890 E GEMINI DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3253
Mailing Address - Country:US
Mailing Address - Phone:480-766-8380
Mailing Address - Fax:
Practice Address - Street 1:2345 S ALMA SCHOOL RD STE 105
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4013
Practice Address - Country:US
Practice Address - Phone:480-442-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16938101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor