Sandra M Peacock, APRN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

AP02623 Issued in LA

Practice address

423 Cypress St
Sulphur, LA 70663-4964

Phone

(337) 528-7992

Fax

(337) 528-7994

NPI assigned

Mar 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

Practice roles

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.

• Journey Behavioral Health, LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Sulphur, LA
  • NPI 1295065241
  NPD (past)

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1780909036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 CYPRESS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706634964",
            "telephone_number": "337-528-7992",
            "fax_number": "337-528-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 CYPRESS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706634964",
            "telephone_number": "337-528-7992",
            "fax_number": "337-528-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "LA",
            "license": "AP02623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optics Unlimited Inc
• Rachel Palermo
• Dana Frances Papania, LCSW
• Paraoccdocs, LLC
• Pathways ABA Therapy LLC
• Peak Performance Physical Therapy & Sports Rehab, LLC
• Pedi Physical Therapy
• Pediatric Therapy of Swla
• Paul C. Perry, D.D.S., M.S.
• Julie P. Peterson, P.T.

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Sulphur, LA
• Providers in Sulphur, LA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.