Active NPI
Marianne Peck, MFT
- Mental Health Counselor
- Modesto, CA
National Provider Identifier
1487674636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFC17999
- Practice address
- 1101 Standiford Ave
Suite B 2
Modesto, CA 95350-0982 - Phone
- (209) 631-7099
- Fax
- (209) 522-5134
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFC17999 | CA | Primary |
Addresses
Primary practice location
1101 Standiford Ave
Suite B 2
Modesto, CA 95350-0982
Mailing address
1101 Standiford Ave
Suite B 2
Modesto, CA 95350-0982
Phone (209) 631-7099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770044810 | Other | CA | T.I.D. |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC17999 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514419200000",
"number": "1487674636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 STANDIFORD AVE",
"address_2": "SUITE B 2",
"city": "MODESTO",
"state": "CA",
"postal_code": "953500982",
"telephone_number": "209-631-7099",
"fax_number": "209-522-5134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 STANDIFORD AVE",
"address_2": "SUITE B 2",
"city": "MODESTO",
"state": "CA",
"postal_code": "953500982",
"telephone_number": "209-631-7099",
"fax_number": "209-522-5134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "MARIANNE",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2017-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFC17999",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "T.I.D.",
"identifier": "770044810",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.