Provider Demographics
NPI:1992746549
Name:MCPEAK, EMILY GRIFFIN (LCSW, LCAS, CCS)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:GRIFFIN
Last Name:MCPEAK
Suffix:
Gender:F
Credentials:LCSW, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 GREENHILL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-2320
Mailing Address - Country:US
Mailing Address - Phone:336-783-6919
Mailing Address - Fax:336-783-6923
Practice Address - Street 1:284 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1831
Practice Address - Country:US
Practice Address - Phone:704-939-1100
Practice Address - Fax:704-939-1173
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0047871041C0700X
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003125Medicaid