Provider Demographics
NPI:1518199488
Name:PECK, LINDA S (LCAT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:PECK
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 W 26TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1058
Mailing Address - Country:US
Mailing Address - Phone:212-696-1550
Mailing Address - Fax:212-696-1602
Practice Address - Street 1:37 W 26TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1058
Practice Address - Country:US
Practice Address - Phone:212-696-1550
Practice Address - Fax:212-696-1602
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000445-1OtherLCAT