Provider Demographics
NPI:1215598305
Name:PEACOCK, LUCIANA (LPC)
Entity Type:Individual
Prefix:
First Name:LUCIANA
Middle Name:
Last Name:PEACOCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 OPAL SHORES CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0110
Mailing Address - Country:US
Mailing Address - Phone:281-705-5487
Mailing Address - Fax:
Practice Address - Street 1:9215 OPAL SHORES CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-0110
Practice Address - Country:US
Practice Address - Phone:281-705-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77150101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health