Provider Demographics
NPI:1982925699
Name:PEACE, RICHARD TROY (LPCC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:TROY
Last Name:PEACE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MANIACAL WAY
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:KY
Mailing Address - Zip Code:41046-1102
Mailing Address - Country:US
Mailing Address - Phone:859-567-4430
Mailing Address - Fax:859-567-4438
Practice Address - Street 1:2816 BLUEGRASS DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-1577
Practice Address - Country:US
Practice Address - Phone:859-442-8500
Practice Address - Fax:859-442-8555
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1052101YM0800X
KY104568101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER