NPIMap

Organization Active NPI

Lisa Davis Peck

  • Addiction (Substance Use Disorder) Counselor
  • Indianapolis, IN
National Provider Identifier
1134572308
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
87001460A
Legal business name
LISA DAVIS PECK
Practice address
6644 Greendale LN
Indianapolis, IN 46241-1068
Phone
(317) 919-8482
NPI assigned
Jul 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Authorized official

Name
Lisa Marcella Davis Peck, LMHC, LMFT, LCACNPI 1912346271
Title
Owner President
Phone
(317) 919-8482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 87001460A Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 39001382A IN
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 35001131A IN

Addresses

Primary practice location

6644 Greendale LN
Indianapolis, IN 46241-1068

Mailing address

6644 Greendale LN
Indianapolis, IN 46241-1068
Phone (317) 919-8482

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1134572308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6644 GREENDALE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462411068",
            "telephone_number": "317-919-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 GREENDALE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462411068",
            "telephone_number": "317-919-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA DAVIS PECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS PECK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARCELLA",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "317-919-8482",
        "authorized_official_credential": "LMHC, LMFT, LCAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "87001460A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001382A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001131A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.