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General NPI Number Information
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NPI Number | 1477604650
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Entity Type | Individual
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Provider Name | PEGGY BICE LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 708 GLEN COVE AVE
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City | GLEN HEAD
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State | NY
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Zip | 11545-1655
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Country | US
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Telephone | 516-671-6051
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Fax |
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Provider Business Mailing Address
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Address Line | 28 LINDA LN
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City | NEW FAIRFIELD
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State | CT
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Zip | 06812-2430
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Country | US
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Telephone | 516-671-6051
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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 | R047148-1
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License Number State | NY
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