Individual
LISA M DAVIS PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LMFT
Contact information
Practice address
24 S LYNHURST DR, INDIANAPOLIS, IN 46241-1230
(317) 919-8482
(317) 203-0983
Mailing address
6644 GREENDALE LN, INDIANAPOLIS, IN 46241-1068
(317) 919-8482
(317) 203-0983
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001460A
IN
101YM0800X
Mental Health Counselor
Primary
39001382A
IN
106H00000X
Marriage & Family Therapist
35001131A
IN
Other
Enumeration date
06/20/2013
Last updated
09/16/2016
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