Provider Demographics
NPI:1295353472
Name:PEAKE, KIMEKA L (LPC)
Entity type:Individual
Prefix:MS
First Name:KIMEKA
Middle Name:L
Last Name:PEAKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KIMEKA
Other - Middle Name:L
Other - Last Name:PEAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:213 E DORCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-2450
Mailing Address - Country:US
Mailing Address - Phone:704-641-4413
Mailing Address - Fax:
Practice Address - Street 1:129 BLOXOME DR
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:SC
Practice Address - Zip Code:29061-8225
Practice Address - Country:US
Practice Address - Phone:803-770-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health