Individual provider Active NPI

Joan C Peery

  • Mental Health Counselor
  • Austin, TX
National Provider Identifier
1386894665
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
66018 Issued in TX
Practice address
3501 South First Street Apt 153
Austin, TX 78704
Phone
(802) 999-2484
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0680000740 VT
Mental Health Counselor 101YM0800X MH9216 FL
Mental Health Counselor 101YM0800X 66018 TX Primary
Mental Health Counselor 101YM0800X 6981 MA

Addresses

Primary practice location

3501 South First Street Apt 153
Austin, TX 78704

Mailing address

3501 S 1St St Apt 153
Austin, TX 78704-7005
Phone (802) 999-2484

Other identifiers 3

IdentifierTypeStateIssuer
1001510OtherMANHP
1319744MedicaidMA
8411OtherMABMC

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

LicenseStateTypeSpecialty
MH9216FLMDMental Health Counselor
6981MAMDMental Health Counselor
0680000740VTMDMental Health Counselor
66018TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1386894665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S 1ST ST APT 153",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047005",
            "telephone_number": "802-999-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SOUTH FIRST STREET APT 153",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78704",
            "telephone_number": "802-999-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEERY",
        "first_name": "JOAN",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "0680000740",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9216",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "66018",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6981",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "1001510",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319744",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "8411",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.