Provider Demographics
NPI:1780081042
Name:PELTIER, ADAM (LISW-S)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:PELTIER
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 N GRANT AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2855
Mailing Address - Country:US
Mailing Address - Phone:888-522-9174
Mailing Address - Fax:614-928-9092
Practice Address - Street 1:195 N GRANT AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2855
Practice Address - Country:US
Practice Address - Phone:888-522-9174
Practice Address - Fax:614-928-9092
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1302985.SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical