1578795639 NPI number — KATHERINE ELIZABETH PEEK LPC

Table of content: KATHERINE ELIZABETH PEEK LPC (NPI 1578795639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578795639 NPI number — KATHERINE ELIZABETH PEEK LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEEK
Provider First Name:
KATHERINE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BISBEE
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1578795639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8408 E MINERAL CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-2745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-489-9579
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2855 N SPEER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80211-4239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-489-9579
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)