Provider Demographics
NPI:1740301597
Name:PEYTON, H. JACKSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:H.
Middle Name:JACKSON
Last Name:PEYTON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 BEEKMAN PL NW APT D
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4082
Mailing Address - Country:US
Mailing Address - Phone:202-667-1375
Mailing Address - Fax:202-667-1375
Practice Address - Street 1:4000 ALBEMARLE ST NW STE 502
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1856
Practice Address - Country:US
Practice Address - Phone:202-667-1375
Practice Address - Fax:202-667-1375
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000338103TC0700X
CAPSY20924103TC0700X
MD04198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical