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Contact Information

TASHA M PEACOCK
5332 HOLLYWOOD AVE
MAPLE HEIGHTS, OH44137
 Phone: 330-983-7422
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for TASHA M PEACOCK · (Female)

NPI # 1477308773
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2024
Last updated 04/19/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # CHW002436
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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