NPIMap

Organization Active NPI

Stephanie Knatz Peck PHD Psychological Services Inc

Doing business as BrightMind Therapy

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1881307544
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
STEPHANIE KNATZ PECK PHD PSYCHOLOGICAL SERVICES INC
Doing business as
BrightMind Therapy
Practice address
1010 Turquoise St Ste 303
San Diego, CA 92109-1268
Phone
(858) 255-4095
Fax
(619) 566-3845
NPI assigned
Dec 27, 2022
Last updated
Nov 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Stephanie Knatz Peck, PHD
Title
Owner/Director
Phone
(858) 255-4095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1010 Turquoise St Ste 303
San Diego, CA 92109-1268

Mailing address

1010 Turquoise St Ste 303
San Diego, CA 92109-1268
Phone (858) 255-4095

Other names 1

  • BrightMind Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1010 Turquoise St
Ste 303
San Diego, CA 92109
Phone (619) 407-8812

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1881307544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 TURQUOISE ST STE 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921091268",
            "telephone_number": "858-255-4095",
            "fax_number": "619-566-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 TURQUOISE ST STE 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921091268",
            "telephone_number": "858-255-4095",
            "fax_number": "619-566-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE KNATZ PECK PHD PSYCHOLOGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2023-11-15",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "KNATZ PECK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "858-255-4095",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BrightMind Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BrightMind Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.