Active NPI
Holly L. Peck, LCSW
- Clinical Social Worker
- Langley Afb, VA
National Provider Identifier
1174963094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- BBH-LCSW-LIC-8574
- Practice address
- 190 E Flight Line Rd
Langley Afb, VA 23665 - Phone
- (757) 298-5942
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | BBH-LCSW-LIC-8574 | MT | Primary |
Addresses
Primary practice location
190 E Flight Line Rd
Langley Afb, VA 23665
Mailing address
190 E Flight Line Rd
Langley Afb, VA 23665
Phone (757) 298-5942
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 |
|---|---|---|---|
| BBH-LCSW-LIC-8574 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696550400000",
"number": "1174963094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E FLIGHT LINE RD",
"city": "LANGLEY AFB",
"state": "VA",
"postal_code": "23665",
"telephone_number": "757-298-5942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 E FLIGHT LINE RD",
"city": "LANGLEY AFB",
"state": "VA",
"postal_code": "23665",
"telephone_number": "757-298-5942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "HOLLY",
"middle_name": "L.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "BBH-LCSW-LIC-8574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Langley Afb, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.