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General NPI Number Information
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NPI Number | 1477601615
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Entity Type | Individual
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Provider Name | PHILLIP A. MCPEEK MSW
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Gender | Male
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 455 BARCLAY CIR STE C-1
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4774
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Country | US
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Telephone | 248-852-1282
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 INDIANWOOD RD
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City | LAKE ORION
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State | MI
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Zip | 48362-1212
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Country | US
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Telephone | 248-693-1817
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801001053
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License Number State | MI
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