Provider Demographics
NPI:1639130370
Name:NAGEL, PETER EDWARD JR (LMFT, CGP)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:EDWARD
Last Name:NAGEL
Suffix:JR
Gender:M
Credentials:LMFT, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-9498
Mailing Address - Country:US
Mailing Address - Phone:336-626-5989
Mailing Address - Fax:
Practice Address - Street 1:325 PAGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8751
Practice Address - Country:US
Practice Address - Phone:910-235-0900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC83101YA0400X
NC978101YP2500X
NC680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist