Individual provider Active NPI

Peggy Kubiak

  • Mental Health Counselor
  • Toledo, OH
National Provider Identifier
1740652825
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I1501259 Issued in OH
Practice address
1946 N 13TH St Ste 420
Toledo, OH 43604-7264
Phone
(419) 720-9247
Fax
(419) 720-0304
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I1501259 OH Primary

Addresses

Primary practice location

1946 N 13TH St Ste 420
Toledo, OH 43604-7264

Mailing address

1946 N 13TH St Ste 420
Toledo, OH 43604-7264
Phone (419) 720-9247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170524002029 OH Practitioner - Clinical Social Worker 8426325309 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1501259OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 23, 2024 Accepting new patients
Linking Families Therapy Group LLC Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

4651 N Summit St
Toledo, OH 43611
Phone (419) 407-5100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1740652825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 N 13TH ST STE 420",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047264",
            "telephone_number": "419-720-9247",
            "fax_number": "419-720-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 N 13TH ST STE 420",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047264",
            "telephone_number": "419-720-9247",
            "fax_number": "419-720-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "PEGGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I1501259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.