Individual
PETER L MAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
130 MAIN STREET, SUITE 200, MENASHA, WI 54952
(920) 379-7769
Mailing address
130 MAIN STREET, SUITE 200, MENASHA, WI 54952
(920) 379-7769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15332-132
WI
101YP2500X
Professional Counselor
Primary
3461-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40969100
—
WI
Enumeration date
07/10/2007
Last updated
07/07/2016
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