Individual provider Active NPI

Liria Peshkepia, M.ED., LPC

  • Professional Counselor
  • Tupelo, MS
National Provider Identifier
1245838143
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2222 Issued in MS
Practice address
1105 W Jackson St
Tupelo, MS 38804-2515
Phone
(662) 471-4055
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2222 MS Primary

Addresses

Primary practice location

1105 W Jackson St
Tupelo, MS 38804-2515

Mailing address

629 Highland Cir
Tupelo, MS 38804-2003
Phone (662) 471-4055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20241022003016 MS Practitioner - Mental Health Counselor 1759813215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 E Main St
Suite B
Tupelo, MS 38804-4017
Phone (662) 471-4055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Pax House Counseling and Play Therapy LLC Professional CurrentSince Aug 6, 2024 Accepting new patients

Locations

210 E Main St
Ste B
Tupelo, MS 38804
Phone (662) 471-4055

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.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1245838143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 HIGHLAND CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388042003",
            "telephone_number": "662-471-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W JACKSON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388042515",
            "telephone_number": "662-471-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESHKEPIA",
        "first_name": "LIRIA",
        "credential": "M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.