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General NPI Number Information
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NPI Number | 1629770029
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Entity Type | Individual
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Provider Name | GRAHAM PECK LMHC, MTBC
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Gender | Male
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 18 LYMAN ST STE 250
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1472
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Country | US
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Telephone | 508-366-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 190 ELSINORE ST
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City | CONCORD
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State | MA
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Zip | 01742-2314
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Country | US
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Telephone | 978-505-2951
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 16657
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC10005375
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License Number State | MA
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