Organization Active NPI

Peaceful Pathways LLC

  • Clinical Social Worker
  • Peru, IN
National Provider Identifier
1689420275
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PEACEFUL PATHWAYS LLC
Doing business as
Peace of Mind
Practice address
2484 S Business 31 Ste D
Peru, IN 46970-7325
Phone
(765) 472-2722
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Leigh Gibbs, LCSWNPI 1073371274
Title
Owner
Phone
(765) 480-1050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2484 S Business 31 Ste D
Peru, IN 46970-7325

Mailing address

2484 S Business 31 Ste D
Peru, IN 46970-7325

Other identifiers 4

IdentifierTypeStateIssuer
1073371274MedicaidIN
1346824729OtherINCOMMERCIAL
1346824729MedicaidIN
1073371274OtherINCOMMERCIAL

Other names 1

  • Peace of Mind Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240522002223 IN Part B Supplier - Clinic/Group Practice 9436591443 Receives reassigned benefits from 2 practitioners
Practice locations: Peru, IN

National Provider Directory

National Provider Directory

Locations

2484 S Business 31
Ste D
Peru, IN 46970
Phone (765) 472-2722

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1689420275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 S BUSINESS 31 STE D",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469707325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 S BUSINESS 31 STE D",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469707325",
            "telephone_number": "765-472-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL PATHWAYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-480-1050",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073371274",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1346824729",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346824729",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1073371274",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace of Mind",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peru, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.