Evelyn Anne Peck, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

297688 Issued in KY

Practice address

948 Elm St Ste 2
Bowling Green, KY 42101-2277

Phone

(270) 266-1188

NPI assigned

Jun 12, 2007

Last updated

Dec 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Evelyn Anne De Villiers Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harden and Skaggs Inc.

  dba The Cognitive Refinery

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1508220609

  Multi-Specialty

  NPD
• Northern Inyo Healthcare District

  dba Northern Inyo Hospital Rural Health Clinic

  • Rural Health Clinic/Center
  • Bishop, CA
  • NPI 1417032921
  NPD
• Mindful Neuropsychology Professional Corporation

  • Psychologist
  • San Diego, CA
  • NPI 1366717845
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1629272984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 ELM ST STE 2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012277",
            "telephone_number": "270-266-1188",
            "fax_number": "270-908-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 ELM ST STE 2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012277",
            "telephone_number": "270-266-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Pioneer Ln Ste B",
            "address_purpose": "LOCATION",
            "city": "Bishop",
            "state": "CA",
            "postal_code": "935142517",
            "country_code": "US",
            "telephone_number": "760-873-2849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9255 Towne Centre Dr",
            "address_2": "Suite 875",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213033",
            "country_code": "US",
            "telephone_number": "858-824-9458",
            "fax_number": "858-455-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "EVELYN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18687",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "297688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evelyn.devilliers@nih.org",
            "affiliation": "N",
            "endpointDescription": "Rural Health Clinic End Point",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "153 Pioneer Ln Ste B",
            "city": "Bishop",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935142517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evelyn.devilliers@nih.org",
            "affiliation": "N",
            "endpointDescription": "Rural Health Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "153 Pioneer Ln Ste B",
            "city": "Bishop",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935142517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "DE VILLIERS",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendy Leanne Pearce, CRNA
• Amy Pearson
• Andrea Jane Pearson, RPH
• Charles Christopher Pearson, RPH
• Whitney Dawn Peay, LPCC, NCC
• Lindsey Peden
• Pediatric Associates of Bowling Green, LLC
• Pediatric Dentistry of Southern Kentucky (SKY Pediatric Dentistry)
• Joshua A Pedigo, M.D.
• Lereasa Lynne Pedigo, CADC

• Clinical Psychologist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.