Paul Thomas Peavy, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH4440 Issued in FL

Practice address

1678 Copperfield Cir
Tallahassee, FL 32312-3791

Phone

(850) 264-5033

Fax

(850) 907-0237

NPI assigned

Feb 3, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Brightside Health, Inc.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1073072658

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1912045584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1678 COPPERFIELD CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323123791",
            "telephone_number": "850-264-5033",
            "fax_number": "850-907-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 COPPERFIELD CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323123791",
            "telephone_number": "850-264-5033",
            "fax_number": "850-907-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAVY",
        "first_name": "PAUL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76084033",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tarvis Peacock, MD
• Anne Pearce, RN, BSN
• Katreena Pearson
• Melissa Rolfe Pearson, FNP-C
• Robert S Pearson, DPM
• Bianca F Peck, APRN
• Debra Pedersen, ARNP
• Pediatria Healthcare, LLC
• Pediatria Healthcare, LLC (Aveanna Healthcare)
• Pediatria Healthcare, LLC

• Mental Health Counselor in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.