Mishon Peck

Individual provider Active NPI Clinical Social Worker · Naples, NY

NPI 1689415663 · NPPES record last updated Sep 10, 2025

Key facts

NPI
1689415663
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
099955 (NY)
Practice address
7113 Gulick Rd
Naples, NY 14512-9129
Phone
(209) 614-7499
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250424000399 NY Practitioner - Clinical Social Worker 8729504667 Reassigns benefits to 1 organization
Practice locations: Canandaigua, NY

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
105902NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Mental Health Current
since Apr 21, 2025
Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 099955 NY Yes
Social Worker 104100000X 105902 NY

Addresses

Primary practice location

7113 Gulick Rd
Naples, NY 14512-9129

Mailing address

7113 Gulick Rd
Naples, NY 14512-9129
Phone (209) 614-7499

Other practice location 1

3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256 ext. 49256

Other providers in Naples, NY

All providers in Naples, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.