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:
Health care specialties
Specialty | Code | License # | 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 4 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225505803 | NPPES |
Connecticut | Other | 003726 | LICENSE |
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