Provider Demographics
NPI:1013373315
Name:PEEKS, DANIEL (LAPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PEEKS
Suffix:
Gender:M
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CHURCH ST NE STE 350
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8642
Mailing Address - Country:US
Mailing Address - Phone:770-425-8275
Mailing Address - Fax:770-426-8276
Practice Address - Street 1:127 CHURCH ST NE STE 350
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8642
Practice Address - Country:US
Practice Address - Phone:770-425-8275
Practice Address - Fax:770-426-8276
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health