Active NPI 1871600825 Individual Practitioner Male Practitioner

Larry Dean Peacock , LPC, CSAC

Counselor - Professional • Chantilly, VA

Professional Overview & Biography Verified Profile Summary

Larry Peacock, LPC, CSAC is a registered healthcare professional specializing in Counselor - Professional in Chantilly, VA. Practice services are available at 4213 WALNEY RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4213 Walney Rd

Chantilly, VA 201512923

Telephone 7035027039

Fax 7035027055

Associated Practice Facility / Clinic

🏢 Fairfax Falls Church Community Service Board Facility NPI 1104161736

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Chantilly, VA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 15.6 Yrs

State Avg: 14.7 Yrs

Regional Practice Density

40 Specialists

Practicing in Chantilly, VA (6609 Statewide)

Telehealth Adoption Rate

10.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License VA 0701003461

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Janelle Grike , RN

Registered Nurse

NPI 1306951058

Registered Nurse

Cecil Garrison , LCSW, LSATP

Social Worker - Clinical

NPI 1548372915

Licensed Clinical Social Worker, LSATP

John Breau , RN

Registered Nurse

NPI 1588724066

Registered Nurse

Jane Stevens , RN

Registered Nurse - Addiction (Substance Use Disorder)

NPI 1851445712

Registered Nurse

Rosaline Nankam , RN

Registered Nurse

NPI 1942353198

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 4213 WALNEY RD, CHANTILLY, VA 201512923 (Tel: 7035027039)

📍

Updated Business Mailing Address July 08, 2007

Registered at 6614 CUSTER ST, SPRINGFIELD, VA 221501501 (Tel: 7039226544)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as LARRY PEACOCK, LPC, CSAC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #0701003461 in VA)

🟢

Initial NPI Registration & Enumeration August 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1871600825

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 24, 2006

Last Update: July 08, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

6614 Custer St

Springfield, VA 221501501

Phone: 7039226544

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.