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NPI Code Detail

MEDICARE: PETER STERRETT LCSW

MEDICARE: PETER STERRETT LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904002496VA
21041C0700XClinical Social WorkerC005505NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2776769000OTHERVAMAGELLAN HEALTH SERVICES
39374511OTHERVAPHCS

General Provider Information

NPI Number : 1033111398
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER STERRETT LCSW
Provider Business Mailing Address
First Line : 1005 SENOMA PL
Second Line :
City : APEX
State : NC
Zip : 27502-8982
Country : US
Telephone Number : 919-303-3425
Fax Number : 919-226-0026
Provider Business Practice Location Address
First Line : 433 W MAIN ST
Second Line :
City : DURHAM
State : NC
Zip : 27701-3217
Country : US
Telephone Number : 919-433-0170
Fax Number : 919-226-0026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/08/2007

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Directions to “ PETER STERRETT LCSW” Practice Location

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