Provider Demographics
NPI:1164857165
Name:NORWOOD, PEGGY DANIELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:DANIELLE
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91491
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-1491
Mailing Address - Country:US
Mailing Address - Phone:818-854-2528
Mailing Address - Fax:
Practice Address - Street 1:146 N HOLLISTON AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1911
Practice Address - Country:US
Practice Address - Phone:626-788-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF83039101YM0800X, 106H00000X
CA83039106H00000X
CALMFT109809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health