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NPI Code Detail

MEDICARE: JESSICA PEACHEY LMHC

MEDICARE: JESSICA PEACHEY LMHC
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
1101YM0800XMental Health Counselor39002486AIN

General Provider Information

NPI Number : 1386070266
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA PEACHEY LMHC
Provider Business Mailing Address
First Line : 21769 COUNTY ROAD 45
Second Line :
City : GOSHEN
State : IN
Zip : 46528-5810
Country : US
Telephone Number : 574-361-7400
Fax Number :
Provider Business Practice Location Address
First Line : 17195 CLEVELAND RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46635-1415
Country : US
Telephone Number : 574-277-0274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2013
Last Update Date : 11/03/2024

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Directions to “ JESSICA PEACHEY LMHC” Practice Location

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