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General NPI Number Information
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NPI Number | 1740301597
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Entity Type | Individual
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Provider Name | H. JACKSON PEYTON PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4000 ALBEMARLE ST NW STE 502
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City | WASHINGTON
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State | DC
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Zip | 20016-1856
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Country | US
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Telephone | 202-667-1375
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Fax | 202-667-1375
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Provider Business Mailing Address
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Address Line | 1624 BEEKMAN PL NW APT D
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City | WASHINGTON
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State | DC
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Zip | 20009-4082
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Country | US
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Telephone | 202-667-1375
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Fax | 202-667-1375
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000338
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY20924
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04198
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License Number State | MD
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