Provider Demographics
NPI:1245369552
Name:PECK, LINDA L
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:L
Last Name:PECK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:L
Other - Last Name:PECK-ALLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP PLADC CEAP
Mailing Address - Street 1:PO BOX 6132
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0132
Mailing Address - Country:US
Mailing Address - Phone:402-438-3037
Mailing Address - Fax:800-780-8312
Practice Address - Street 1:610 J ST
Practice Address - Street 2:SUITE 30
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2967
Practice Address - Country:US
Practice Address - Phone:402-438-3037
Practice Address - Fax:402-420-6265
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-307101YA0400X
NE1068101YM0800X
NE686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE85071OtherBLUE CROSS
NE10025470200Medicaid