Active NPI
Virginia Ellaine Peck
- Professional Counselor
- Palm Beach Gardens, FL
National Provider Identifier
1063112290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MH17350
- Practice address
- 4951 Bonsai Cir Apt 211
Palm Beach Gardens, FL 33418-6774 - Phone
- (561) 371-9966
- NPI assigned
- Mar 7, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MH17350 | FL | Primary |
Addresses
Primary practice location
4951 Bonsai Cir Apt 211
Palm Beach Gardens, FL 33418-6774
Mailing address
4951 Bonsai Cir Apt 211
Palm Beach Gardens, FL 33418-6774
Phone (561) 371-9966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH17350 | FL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1063112290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4951 BONSAI CIR APT 211",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334186774",
"telephone_number": "561-371-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4951 BONSAI CIR APT 211",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334186774",
"telephone_number": "561-371-9966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "VIRGINIA",
"middle_name": "ELLAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-07",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "FL",
"license": "MH17350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
- Peacemaking of the Human Spirit
- Carisa Karin Pearce, M.D.
- Duane Pearson, APRN
- Keith Peart
- Peartree Eyecare PA
- Pediatric and Adult Dentistry of the Palm Beaches PLLC
- Pediatric Dermatology of the Palm Beaches
- Pediatric Endocrine & Diabetes Specailists, PA
- Pediatric Partners of Palm Beach County
- Pediatric Partners of Palm Beach County, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.