NPIMap

Organization Active NPI

Peer Recovery Consultants

  • Peer Specialist
  • Wilmington, MA
National Provider Identifier
1265219620
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
PEER RECOVERY CONSULTANTS
Practice address
41A Lake St
Wilmington, MA 01887-3728
Phone
(617) 643-9194
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Dr. David Eddie, PHDNPI 1043691744
Title
Director
Phone
(617) 643-9194

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
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

41A Lake St
Wilmington, MA 01887-3728

Mailing address

41A Lake St
Wilmington, MA 01887-3728
Phone (617) 643-9194

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1265219620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41A LAKE ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018873728",
            "telephone_number": "617-643-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41A LAKE ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018873728",
            "telephone_number": "617-643-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEER RECOVERY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "EDDIE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-643-9194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.