Provider Demographics
NPI:1417961210
Name:PECK, BARBARA H (EDD)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:H
Last Name:PECK
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:622 LOUISE CT
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2274
Mailing Address - Country:US
Mailing Address - Phone:724-344-6814
Mailing Address - Fax:
Practice Address - Street 1:1121 BOYCE RD STE 1950
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-4022
Practice Address - Country:US
Practice Address - Phone:724-344-6814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002268101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty