Active NPI
Jennifer Peck, LCSW
- Social Worker
- Newport, PA
National Provider Identifier
1043786031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CW022634
- Practice address
- 28 W Shortcut Rd
Newport, PA 17074-8721 - Phone
- (717) 567-3524
- Fax
- (717) 567-3581
- NPI assigned
- Oct 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CW022634 | PA | Primary |
Addresses
Primary practice location
28 W Shortcut Rd
Newport, PA 17074-8721
Mailing address
28 W Shortcut Rd
Newport, PA 17074-8721
Phone (717) 567-3524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 11, 2024 through Mar 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW022634 | PA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J.Peck Counseling LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1043786031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 W SHORTCUT RD",
"city": "NEWPORT",
"state": "PA",
"postal_code": "170748721",
"telephone_number": "717-567-3524",
"fax_number": "717-567-3581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 W SHORTCUT RD",
"city": "NEWPORT",
"state": "PA",
"postal_code": "170748721",
"telephone_number": "717-567-3524",
"fax_number": "717-567-3581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-17",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "CW022634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.