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Organization
PEAK BEHAVIORAL HEALTH, LLC
Active
Organization
PEAK BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PORSCHE PEAK LMFT, LADC (DIRECTOR, CLINICAL THERAPIST)
(651) 493-2055
Entity
Organization
Contact information
Practice address
2864 MIDDLE ST STE 100, LITTLE CANADA, MN 55117-1411
(651) 493-2055
(651) 340-8632
Mailing address
2864 MIDDLE ST STE 100, LITTLE CANADA, MN 55117-1411
(651) 493-2055
(651) 340-8632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
172V00000X
Community Health Worker
—
NULL
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
03/07/2019
Last updated
03/25/2019
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