Provider Demographics
NPI:1225307606
Name:PEYTON, DEDRICK D (LMHC)
Entity Type:Individual
Prefix:MR
First Name:DEDRICK
Middle Name:D
Last Name:PEYTON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 NEW BEDFORD PL
Mailing Address - Street 2:APT 202
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4691
Mailing Address - Country:US
Mailing Address - Phone:407-902-7788
Mailing Address - Fax:407-647-4628
Practice Address - Street 1:260 LOOKOUT PL
Practice Address - Street 2:SUITE 202
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4485
Practice Address - Country:US
Practice Address - Phone:407-647-1781
Practice Address - Fax:407-647-4628
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health