Active NPI
Courtney Peck, LCSW
- Counselor
- Poulsbo, WA
National Provider Identifier
1972073682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- SWIA.SC.60856259
- Practice address
- 17791 Fjord Dr NE Ste 122
Poulsbo, WA 98370-8482 - Phone
- (360) 930-4497
- NPI assigned
- Nov 26, 2018
- Last updated
- Nov 26, 2018
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | SWIA.SC.60856259 | WA | Primary |
Addresses
Primary practice location
17791 Fjord Dr NE Ste 122
Poulsbo, WA 98370-8482
Mailing address
2040 NW Tregaten LN
Poulsbo, WA 98370-7101
Phone (360) 930-4497
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 |
|---|---|---|---|
| SWIA.SC.60856259 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1972073682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 NW TREGATEN LN",
"city": "POULSBO",
"state": "WA",
"postal_code": "983707101",
"telephone_number": "360-930-4497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17791 FJORD DR NE STE 122",
"city": "POULSBO",
"state": "WA",
"postal_code": "983708482",
"telephone_number": "360-930-4497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "COURTNEY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-26",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "SWIA.SC.60856259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.