Provider Demographics
NPI:1477608438
Name:NASH, PEGGY BRICKSON (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:BRICKSON
Last Name:NASH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 FAIRCREST DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-1411
Mailing Address - Country:US
Mailing Address - Phone:214-750-8488
Mailing Address - Fax:214-348-4483
Practice Address - Street 1:7557 RAMBLER RD STE 802
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2339
Practice Address - Country:US
Practice Address - Phone:214-750-8488
Practice Address - Fax:214-348-4483
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S64RMedicare ID - Type Unspecified