Provider Demographics
NPI:1881465193
Name:PEAKS AND VALLEYS PLLC
Entity type:Organization
Organization Name:PEAKS AND VALLEYS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER AND MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPA
Authorized Official - Phone:336-830-5481
Mailing Address - Street 1:1171 BIG HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8224
Mailing Address - Country:US
Mailing Address - Phone:336-830-5481
Mailing Address - Fax:
Practice Address - Street 1:1171 BIG HILL RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8224
Practice Address - Country:US
Practice Address - Phone:336-830-5481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1578196622OtherNPPES