Provider Demographics
NPI:1659491850
Name:DARMODY, PEGGY (CRC)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:DARMODY
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 MERCURY CIR
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2030
Mailing Address - Country:US
Mailing Address - Phone:651-486-3887
Mailing Address - Fax:
Practice Address - Street 1:1025 DODD RD
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-1113
Practice Address - Country:US
Practice Address - Phone:651-450-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00010978101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional