Provider Demographics
NPI:1861570145
Name:PECK, LEASA ANNE (LPC)
Entity type:Individual
Prefix:MS
First Name:LEASA
Middle Name:ANNE
Last Name:PECK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:839 HILLSIDE AVENUE
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-0006
Mailing Address - Country:US
Mailing Address - Phone:724-785-5787
Mailing Address - Fax:
Practice Address - Street 1:6 BEN LOMOND ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2829
Practice Address - Country:US
Practice Address - Phone:724-425-0223
Practice Address - Fax:724-425-0331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional