| Mr James E Peacock, CSAC, ICS | |
|
36745 Aiken Rd, Bayfield, WI 54814-4579 | |
| (715) 779-3707 | |
| (715) 779-3362 |
| Full Name | Mr James E Peacock |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 36745 Aiken Rd, Bayfield, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588119887 | NPI | - | NPPES |
| 100059919 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 14968-132 (Wisconsin) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 14968132 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr James E Peacock, CSAC, ICS 36745 Aiken Rd, Bayfield, WI 54814-4579 Ph: (715) 779-3707 | Mr James E Peacock, CSAC, ICS 36745 Aiken Rd, Bayfield, WI 54814-4579 Ph: (715) 779-3707 |
Patricia M. Kenote-deperry, Counselor Medicare: Not Enrolled in Medicare Practice Location: 37390 N Bradum Rd, Bayfield, WI 54814 Phone: 715-779-3741 Fax: 715-779-3765 | |
Nicole Renee Gurnoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 36745 Aiken Rd, Bayfield, WI 54814 Phone: 715-779-3707 Fax: 715-779-3711 | |
Tamara L Kolesar, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 36745 Aiken Rd, Bayfield, WI 54814 Phone: 715-779-3707 Fax: 715-779-3362 | |
Mr. Martin A Gordon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 37390 N Bradum Rd, Bayfield, WI 54814 Phone: 715-779-3741 Fax: 715-779-3765 | |
Ms. Bernadette Rock, SACIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 88385 Pike Rd, Bayfield, WI 54814 Phone: 715-779-3741 Fax: 715-779-3765 | |
Ms. Gail Marie Lemieux, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 37390 N Bradum Rd, Bayfield, WI 54814 Phone: 715-779-3741 Fax: 715-779-3765 |