Healthcare Provider Details

I. General information

NPI: 1851153720
Provider Name (Legal Business Name): CODY PECK NCC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 DEKALB ST
NORRISTOWN PA
19401-3415
US

IV. Provider business mailing address

4259 W SWAMP RD STE 404
DOYLESTOWN PA
18902-1033
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-4600
  • Fax:
Mailing address:
  • Phone: 610-892-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC018932
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC018932
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: