Provider Demographics
NPI:1689606089
Name:KINNAIRD, PEYTON LEIGH (LCMHC, LCMHCS)
Entity Type:Individual
Prefix:MS
First Name:PEYTON
Middle Name:LEIGH
Last Name:KINNAIRD
Suffix:
Gender:F
Credentials:LCMHC, LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1608
Mailing Address - Country:US
Mailing Address - Phone:828-775-5535
Mailing Address - Fax:
Practice Address - Street 1:383 MERRIMON AVE STE C
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1223
Practice Address - Country:US
Practice Address - Phone:828-775-5535
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4917101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102701Medicaid