Cassaundra Vawter Peck, LPCS, LCAS, CCS

Individual provider Active NPI Mental Health Counselor · Newport, NC

NPI 1619261237 · NPPES record last updated Sep 26, 2023

Key facts

NPI
1619261237
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
S7997 (NC)
Practice address
103 Heron CT
Newport, NC 28570-8013
Phone
(252) 398-7144
NPI assigned
May 31, 2011
Reactivated
Jul 22, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCAS #1730NCMDAddiction (Substance Use Disorder) Counselor
S7997NCMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS #1730 NC
Mental Health Counselor 101YM0800X S7997 NC Yes

Addresses

Primary practice location

103 Heron CT
Newport, NC 28570-8013

Mailing address

103 Heron CT
Newport, NC 28570-8013

Other providers in Newport, NC

All providers in Newport, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.