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General NPI Number Information
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NPI Number | 1376186387
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Entity Type | Individual
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Provider Name | PETER D PEEDIN LCSW; LCAS
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Gender | Male
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 1410 S. EVANS ST BUILDING 2, SUITE 1
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-689-1509
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Fax |
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Provider Business Mailing Address
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Address Line | 3433 RAINS CROSSROADS RD
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City | PRINCETON
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State | NC
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Zip | 27569-7753
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Country | US
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Telephone | 919-502-9571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21864
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C011392
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License Number State | NC
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