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
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS #1730 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| S7997 | NC | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Newport, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.