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Organization
LISA DAVIS PECK
Active
Organization
LISA DAVIS PECK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARCELLA DAVIS PECK LMHC, LMFT, LCAC (OWNER PRESIDENT)
(317) 919-8482
Entity
Organization
Contact information
Practice address
6644 GREENDALE LN, INDIANAPOLIS, IN 46241-1068
(317) 919-8482
Mailing address
6644 GREENDALE LN, INDIANAPOLIS, IN 46241-1068
(317) 919-8482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001460A
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001460A
—
101YM0800X
Mental Health Counselor
39001382A
IN
106H00000X
Marriage & Family Therapist
35001131A
IN
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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