Peak Longevity LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

005904 Issued in CT

Legal business name

PEAK LONGEVITY LLC

Practice address

451 State St
North Haven, CT 06473-3070

Phone

(203) 281-4325

Fax

(203) 281-4324

NPI assigned

Apr 30, 2018

Organization subpart

No

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

Authorized official

Name

Deborah Marcus, LCSW, LCSW

Title

Director, LCSW

Phone

(203) 281-4325

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1922596360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733070",
            "telephone_number": "203-281-4325",
            "fax_number": "203-281-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733070",
            "telephone_number": "203-281-4325",
            "fax_number": "203-281-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK LONGEVITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "MARCUS, LCSW",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "DIRECTOR, LCSW",
        "authorized_official_telephone_number": "203-281-4325",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005904",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "005904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "140005904CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Parker, LPC
• Sarah Parmelee, PHARMD
• Sweata Patel, APRN
• Tapan Dilipkumar Patel, M.D.
• Tushar C Patel
• Clementina Rose Pecor, LCSW
• Pediatrics Plus PC
• Pediatrics Plus PC
• Stefania Pellegrino, APRN
• McKenzie Pelletier

• Mental Health Clinic/Center (Including Community Mental Health Center) in North Haven, CT
• Providers in North Haven, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.