Porsche Peak, LMFT, LADC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3415 Issued in MN

Practice address

2864 Middle St Ste 100
Little Canada, MN 55117-1411

Phone

(651) 493-2055

Fax

(651) 340-8632

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Peak Behavioral Health, LLC

  • Marriage & Family Therapist
  • Little Canada, MN
  • NPI 1053879023

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1669927273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 MIDDLE ST STE 100",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171411",
            "telephone_number": "651-493-2055",
            "fax_number": "651-340-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 MIDDLE ST STE 100",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171411",
            "telephone_number": "651-493-2055",
            "fax_number": "651-340-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAK",
        "first_name": "PORSCHE",
        "credential": "LMFT, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304885",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsie Olson, DC
• Kayla Oswald
• Paragon Health
• Jin Park, LPCC
• Peak Behavioral Health, LLC
• Julie L Peot, D.C.
• Ondrea Perlman, CNM
• Andrew Robert Peterson, MSW, LICSW
• Phoenix Residence, Inc.
• Pillarpoint Residence LLC

• All providers in Little Canada, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.