Provider Demographics
NPI:1447311980
Name:PECKO, JOSEPH ANTON (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTON
Last Name:PECKO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 MURRAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5100
Mailing Address - Country:US
Mailing Address - Phone:910-273-5044
Mailing Address - Fax:
Practice Address - Street 1:316 MURRAY HILL RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5100
Practice Address - Country:US
Practice Address - Phone:910-273-5044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0015851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical