Provider Demographics
NPI:1518280486
Name:HECTOR, PETER ERIC JR (LMSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ERIC
Last Name:HECTOR
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-1806
Mailing Address - Country:US
Mailing Address - Phone:231-796-1583
Mailing Address - Fax:
Practice Address - Street 1:212 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-1806
Practice Address - Country:US
Practice Address - Phone:231-796-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010706451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical