Thomas Jacob Peek, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401222326 Issued in MI

Practice address

2828 Kraft Ave SE Ste 186
Grand Rapids, MI 49512-2076

Phone

(616) 949-9550

NPI assigned

Nov 10, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Park Counseling PLLCGroup PAC ID 7517340557, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Centennial Park Counseling, PLLC

  • Social Worker
  • Grand Rapids, MI
  • NPI 1689814469
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1124784467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 LANKAMP ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441940",
            "telephone_number": "616-366-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE STE 186",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122076",
            "telephone_number": "616-949-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEK",
        "first_name": "THOMAS",
        "middle_name": "JACOB",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Speech Services LLC
• Pediatric Surgeons of West Michigan PC
• Maureen Tan Pedres, M.D.
• Dorothy A Pedtke, D.O.
• Realite Lanice Peebles, LBA, BCBA
• Sarah Peffers, LMSW
• Timothy John Pegman, LBSW
• Brandee Leigh Peikert, PH.D., LLP
• Margaret Elizabeth Peklo, NP
• Patty Anne Pekras, DDS

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.