Peter D Peedin, LCSW; LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011392 Issued in NC

Practice address

1410 S. Evans St
Building 2, Suite 1
Greenville, NC 27834

Phone

(252) 689-1509

NPI assigned

Oct 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1376186387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 RAINS CROSSROADS RD",
            "city": "PRINCETON",
            "state": "NC",
            "postal_code": "275697753",
            "telephone_number": "919-502-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S. EVANS ST",
            "address_2": "BUILDING 2, SUITE 1",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-689-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEDIN",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "LCSW; LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21864",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siri A Pederson, MS, RDN
• Pediatric Respiratory Care Inc
• Pediatric Services of America, LLC
• Itzayana Pedro-Islas
• Leslie Bone Peedin, M.D.
• Emily Peele
• India Chinyere D'Andrea Peele
• Linda Joyce Peele, L.C.S.W.
• Peer Partners LLC
• Ritvik Peesapati, DO

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.