Individual
MR. JAMES E PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC, ICS
Contact information
Practice address
36745 AIKEN RD, BAYFIELD, WI 54814-4579
(715) 779-3707
(715) 779-3362
Mailing address
36745 AIKEN RD, BAYFIELD, WI 54814-4579
(715) 779-3707
(715) 779-3362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14968132
WI
101YM0800X
Mental Health Counselor
14968-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059919
—
WI
Enumeration date
08/17/2016
Last updated
05/01/2019
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