Alisha Peck, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ALISHA PECK, LMSW

Practice address

668 State St
Boyne City, MI 49712-9129

Phone

(231) 330-2303

NPI assigned

Aug 12, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alisha Peck-MumaNPI 1043765662

Title

Owner/Therapist

Phone

(231) 330-2303

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alisha Peck-Muma, LMSW

  • Clinical Social Worker
  • Boyne City, MI
  • NPI 1043765662
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1033847470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 STATE ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497129129",
            "telephone_number": "231-330-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 STATE ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497129129",
            "telephone_number": "231-330-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALISHA PECK, LMSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "PECK-MUMA",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "231-330-2303"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VS0047322",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Ann Angell, OTR/L
• Ann Holland Professional Counseling PLLC
• Ann T Holland Licensed Professional Counseling PLLC
• Mark C Antonishen, M.D.
• Apollo Medical Group of Northern Michigan PLLC

• Clinical Social Worker in Boyne City, MI
• Providers in Boyne City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.