MEDICARE: PEAK SOLUTIONS COUNSELING

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
1	101YP2500X	Professional Counselor	10980	AZ

General Provider Information

NPI Number	:	1902168123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK SOLUTIONS COUNSELING

Provider Business Mailing Address
First Line	:	849 COVE PKWY
Second Line	:
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-4682
Country	:	US
Telephone Number	:	928-646-0347
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 COVE PKWY
Second Line	:
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-4682
Country	:	US
Telephone Number	:	928-646-0347
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL R KING
Credential	:	LPC
Telephone Number	:	928-646-0347

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/13/2012

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