Active NPI
Robert C Peach, LPCC
- Professional Counselor
- Miamisburg, OH
National Provider Identifier
1912060286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0001647
- Practice address
- 2115 Leiter Rd
Miamisburg, OH 45342-3659 - Phone
- (937) 384-6901
- Fax
- (937) 522-7978
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0001647 | OH | Primary |
| Clinical Social Worker | 1041C0700X | F0000125 | OH | |
| Clinical Social Worker | 1041C0700X | E0001647 | OH | |
| Marriage & Family Therapist | 106H00000X | F125 | OH |
Addresses
Primary practice location
2115 Leiter Rd
Miamisburg, OH 45342-3659
Mailing address
2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 914-7067
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000503182 | Other | OH | ANTHEM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0001647 | OH | MD | Professional Counselor |
| E0001647 | OH | MD | Clinical Social Worker |
| F0000125 | OH | MD | Clinical Social Worker |
| F125 | OH | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1912060286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 LEITER RD",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423660",
"telephone_number": "937-914-7067",
"fax_number": "937-522-7513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 LEITER RD",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423659",
"telephone_number": "937-384-6901",
"fax_number": "937-522-7978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACH",
"first_name": "ROBERT",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "0001647",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "F0000125",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "E0001647",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OH",
"license": "F125",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000503182",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.