Active NPI
Taleesa Peck, PH.D.
- Psychologist
- Gaithersburg, MD
National Provider Identifier
1902536196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 07211
- Practice address
- 656 Quince Orchard Rd Ste 600
Gaithersburg, MD 20878-1418 - Phone
- (202) 417-8647
- NPI assigned
- Jun 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 07211 | MD | Primary |
Addresses
Primary practice location
656 Quince Orchard Rd Ste 600
Gaithersburg, MD 20878-1418
Mailing address
656 Quince Orchard Rd Ste 600
Gaithersburg, MD 20878-1418
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07211 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1902536196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 QUINCE ORCHARD RD STE 600",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208781418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "656 QUINCE ORCHARD RD STE 600",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208781418",
"telephone_number": "202-417-8647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "TALEESA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-12",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "07211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.