Charles A Peck, LCSW
Social Worker, Clinical in Bridgeport, CT. Individual provider (NPI-1).
NPI number1942703608
StatusActive
Last updated in NPPESNov 22, 2024
Details
- NPI
- 1942703608
- Entity type
- Individual (NPI-1)
- Name
- Charles A Peck
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 8, 2018
- Certification date
- Nov 22, 2024
- Last updated
- Nov 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 011789 | CT | Yes |
| 104100000X | Social Worker | – | – |
Practice location
180 Fairfield AveBridgeport, CT 06604
Phone 203-394-6529
Mailing address
180 Fairfield AveBridgeport, CT 06604-4252
Phone 203-394-6529
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