Provider Demographics
NPI:1285195180
Name:PEACOCK, HARRIET (MA, LPC)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:PEACOCK
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 WINDSOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5541
Mailing Address - Country:US
Mailing Address - Phone:251-656-1856
Mailing Address - Fax:
Practice Address - Street 1:1034 23RD ST S STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2462
Practice Address - Country:US
Practice Address - Phone:205-607-1417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4048101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health