Dustin Daniel Peck, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801090454 Issued in MI

Practice address

1090 N 10TH St
Suite 110
Kalamazoo, MI 49009-5733

Phone

(269) 375-4363

NPI assigned

Aug 21, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cornerstone Christian Counseling PC

  • Professional Counselor
  • Kalamazoo, MI
  • NPI 1508090911
  NPD (past)

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1396112629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 117TH AVE",
            "city": "OTSEGO",
            "state": "MI",
            "postal_code": "490789723",
            "telephone_number": "269-365-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST",
            "address_2": "SUITE 110",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "269-375-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "DUSTIN",
        "middle_name": "DANIEL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearle Vision Inc
• Holly Patricia Pearson
• Jeffrey P. Pearson, M.D.
• Kristy Pearson
• Roberta Pearson, RPH
• Stephen L Peck, M.D.
• Lukas Lee Pederson, LPC
• Pediatric Counseling Center, LLC
• Sierra Pedraja
• Brycen Wade Peebles

• Clinical Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.