Provider Demographics
NPI:1669530515
Name:MCCUE, PEGGI KAY (LMHP LADC CPC)
Entity type:Individual
Prefix:
First Name:PEGGI
Middle Name:KAY
Last Name:MCCUE
Suffix:
Gender:F
Credentials:LMHP LADC CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 MACH 1 DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3064
Mailing Address - Country:US
Mailing Address - Phone:402-841-3722
Mailing Address - Fax:
Practice Address - Street 1:2909 MACH 1 DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3064
Practice Address - Country:US
Practice Address - Phone:402-841-3722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1691101YM0800X
NEP254101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE235472OtherMIDLANDS CHOICE PROVIDER
NE47037661201Medicaid
NE47037661202Medicaid
NE47084203426Medicaid
NE6248988OtherUBH PROVIDER #
NE84739OtherBCBS
NE84565OtherBCBS OF NE IND. PROVIDER