Provider Demographics
NPI:1891361705
Name:PEACOCK, BARBRA JEAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARBRA
Middle Name:JEAN
Last Name:PEACOCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 BYRD DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7198
Mailing Address - Country:US
Mailing Address - Phone:970-593-3300
Mailing Address - Fax:
Practice Address - Street 1:4575 BYRD DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7198
Practice Address - Country:US
Practice Address - Phone:970-593-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005812103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist