Provider Demographics
NPI:1598838997
Name:PEAKE, INGRID T (MA, LMFT,RN)
Entity Type:Individual
Prefix:MS
First Name:INGRID
Middle Name:T
Last Name:PEAKE
Suffix:
Gender:F
Credentials:MA, LMFT,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 12TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2775
Mailing Address - Country:US
Mailing Address - Phone:828-327-4590
Mailing Address - Fax:
Practice Address - Street 1:1643 12TH ST NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2775
Practice Address - Country:US
Practice Address - Phone:828-327-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health