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General NPI Number Information
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NPI Number | 1265905509
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Entity Type | Organization
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Legal Business Name | CHARLES B. PEUGH, LMFT, INC,
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 49370 ROAD 426 STE B
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City | OAKHURST
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State | CA
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Zip | 93644-9052
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Country | US
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Telephone | 559-760-1188
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Fax | 559-641-2359
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Provider Business Mailing Address
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Address Line | PO BOX 1765
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City | OAKHURST
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State | CA
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Zip | 93644-1765
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Country | US
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Telephone | 559-760-1188
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Fax | 559-641-2359
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Authorized Official
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Title or Position | CEO
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Name | CHARLES BENJAMIN PEUGH
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Credential | LMFT
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Telephone | 559-760-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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