Provider Demographics
NPI:1700772522
Name:PELTO, DEVON CHUBB (LCSWA, LCASA)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:CHUBB
Last Name:PELTO
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:ELAYNE
Other - Last Name:CHUBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2514 SHENANDOAH AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-4260
Mailing Address - Country:US
Mailing Address - Phone:919-302-1168
Mailing Address - Fax:
Practice Address - Street 1:1800 W LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1133
Practice Address - Country:US
Practice Address - Phone:919-335-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0221681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical