Healthcare Provider Details

I. General information

NPI: 1326861956
Provider Name (Legal Business Name): PEAK VIEW BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 DAGMONT AVE
BARRE VT
05641-5204
US

IV. Provider business mailing address

15 DAGMONT AVE
BARRE VT
05641-5204
US

V. Phone/Fax

Practice location:
  • Phone: 802-917-2949
  • Fax:
Mailing address:
  • Phone: 802-917-2949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL LIRAKIS
Title or Position: OWNER
Credential: M.A., BCBA, LBA
Phone: 802-917-2949