Provider Demographics
NPI:1093865834
Name:PEEL, KARIE G (LCSW)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:G
Last Name:PEEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13241 HIGH CREST RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7770
Mailing Address - Country:US
Mailing Address - Phone:480-586-7161
Mailing Address - Fax:
Practice Address - Street 1:13241 HIGH CREST RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7770
Practice Address - Country:US
Practice Address - Phone:480-586-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 111221041C0700X
MTBBH-LCSW-LIC-202571041C0700X
CA962171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ847668Medicaid