Healthcare Provider Details

I. General information

NPI: 1649784240
Provider Name (Legal Business Name): PEGGY SUE ESCOBEDO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 S 7TH ST
TERRE HAUTE IN
47802
US

IV. Provider business mailing address

27 ALLENDALE
TERRE HAUTE IN
47802-4751
US

V. Phone/Fax

Practice location:
  • Phone: 812-244-3919
  • Fax: 812-234-7575
Mailing address:
  • Phone: 812-244-3919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88000488A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: