Provider Demographics
NPI:1053493650
Name:PEEK, PATRICIA B (LSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:PEEK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:B
Other - Last Name:HOECKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:78 ATLANTIC PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2316
Mailing Address - Country:US
Mailing Address - Phone:207-842-6556
Mailing Address - Fax:207-842-7773
Practice Address - Street 1:12 UNION ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2739
Practice Address - Country:US
Practice Address - Phone:207-701-4400
Practice Address - Fax:207-701-4486
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELS8302104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker