Individual provider Active NPI

Melissa Kaye Peck, LPC

  • Professional Counselor
  • Erie, PA
National Provider Identifier
1902312176
Registry record updated Dec 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC004418 Issued in PA
Practice address
1621 Sassafras St
Erie, PA 16502-1858
Phone
(814) 871-4725
NPI assigned
Dec 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC004418 PA Primary

Addresses

Primary practice location

1621 Sassafras St
Erie, PA 16502-1858

Mailing address

3023 Rudolph Ave
Erie, PA 16508-1045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC004418PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Gertrude a Barber Center Inc PastSince Jul 1, 2004 Accepting new patients
Wellspring of Life, LLC Professional Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/barberinstitute/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513987200000",
    "number": "1902312176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 RUDOLPH AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 SASSAFRAS ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165021858",
            "telephone_number": "814-871-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MELISSA",
        "middle_name": "KAYE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-23",
        "last_updated": "2017-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2017; 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.