Individual provider · Type 1 NPI

Lisa Peacock, LMFT

Mental Health Counselor · Portland, OR

NPI number 1629310990 Active

Practice location

4433 NE 35 Place
Portland, OR 97211

Call (310) 946-5567 Map

Mailing address

4433 NE 35th Pl
Portland, OR 97211-8266

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X51797 (CA)
Mental Health Counselor Primary 101YM0800XT1001 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1629310990

Lisa Peacock, LMFT's National Provider Identifier is 1629310990, issued on Mar 25, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Feb 23, 2016.