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General NPI Number Information
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NPI Number | 1235441460
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Entity Type | Organization
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Legal Business Name | Q COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 301 E BETHANY HOME RD STE C-296
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City | PHOENIX
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State | AZ
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Zip | 85012-1263
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Country | US
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Telephone | 602-570-2373
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 N DAYTON ST
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City | PHOENIX
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State | AZ
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Zip | 85006-2123
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Country | US
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Telephone | 602-570-2373
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL DAVID PECK
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Credential | PHD
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Telephone | 602-570-2373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW12742
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License Number State | AZ
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