Provider Demographics
NPI:1306125844
Name:PEYTON, MICHAEL A (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:PEYTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BRITTANY WAY
Mailing Address - Street 2:MANSION FARM
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2096
Mailing Address - Country:US
Mailing Address - Phone:302-836-5311
Mailing Address - Fax:
Practice Address - Street 1:120 BRITTANY WAY
Practice Address - Street 2:MANSION FARM
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2096
Practice Address - Country:US
Practice Address - Phone:302-836-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical