Peacock, Michelle A

Peacock, Michelle A is an sole proprietor health care provider with primary practice located at 57 Old Post Rd No 2 Ste 206 , Greenwich CT 06830-6786. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Peacock, Michelle A can be contacted via phone (203) 742-0500.

Contact Information

Primary practice address
57 Old Post Rd No 2 Ste 206 Greenwich CT 06830-6786
Phone: (203) 742-0500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X 003726 Connecticut
Behavioral Health & Social Service Providers / Clinical 103TC0700X 003726 Connecticut

Profile Details

NPI number 1225505803
LBN Legal business name Peacock, Michelle A
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2018
Last updated Sep 18th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225505803 NPPES
Connecticut Other 003726 LICENSE

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