Provider Demographics
NPI:1861868085
Name:PEASE, ABBY ELIZABETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:ELIZABETH
Last Name:PEASE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6769 N WICKHAM RD STE B101
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2048
Mailing Address - Country:US
Mailing Address - Phone:321-321-1490
Mailing Address - Fax:
Practice Address - Street 1:6769 N WICKHAM RD STE B101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2048
Practice Address - Country:US
Practice Address - Phone:321-321-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190389861041C0700X
1041C0700X, 171M00000X
FLSW191011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator