Provider Demographics
NPI:1245930783
Name:PECK, ALEXANDRIA N (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:N
Last Name:PECK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MADISON ST STE 306
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3014
Mailing Address - Country:US
Mailing Address - Phone:866-285-2929
Mailing Address - Fax:208-567-5844
Practice Address - Street 1:411 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2141
Practice Address - Country:US
Practice Address - Phone:866-285-2929
Practice Address - Fax:208-567-5844
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99289401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical