Provider Demographics
NPI:1609268507
Name:PEACHEY, CONNIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:ANN
Last Name:PEACHEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:ANN
Other - Last Name:AUMILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 E PARK AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-278-4680
Mailing Address - Fax:814-235-1523
Practice Address - Street 1:1850 E PARK AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6706
Practice Address - Country:US
Practice Address - Phone:814-278-4680
Practice Address - Fax:814-235-1523
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0182521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical