Angela T. Peck, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

08051364 Issued in SD

Practice address

521 N Main Ave
Suite 100
Sioux Falls, SD 57104-5948

Phone

(605) 367-8793

Fax

(605) 367-8247

NPI assigned

Jan 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Angie T. Peck Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1861881880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N MAIN AVE",
            "address_2": "SUITE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571045948",
            "telephone_number": "605-367-8793",
            "fax_number": "605-367-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N MAIN AVE",
            "address_2": "SUITE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571045948",
            "telephone_number": "605-367-8793",
            "fax_number": "605-367-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "ANGELA",
        "middle_name": "T.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "08051364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGIE",
            "last_name": "PECK",
            "middle_name": "T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peak Performance Counseling Center
• Jessica Pearson, M.D.
• Rylan John Dale Pearson, DC
• Anna Peasley
• Jesse Robert Pechous, CRNA
• Shannon R Peck, M.D.
• Nicole Maria Pedersen
• Cole Jason Pederson, COTA
• Jeanette Zespy Pederson, OTR/L
• Kalli Pederson, RDN, LN, CDE

• Addiction (Substance Use Disorder) Counselor in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Addiction (Substance Use Disorder) Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.