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Contact Information

TINA PECK, LCSW
34 W 400 N STE 1
BRIGHAM CITY, UT84302
 Phone: 435-494-1557
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for TINA PECK · (Female)

NPI Number 1164779138
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 08/09/2012
Last updated 08/15/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 9177224-3501
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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