SYREETA A PEACOCK
NPI 1063012045
Counselor - Addiction (Substance Use Disorder) in Fairborn, OH

Q: What is Syreeta Peacock's NPI number?

The NPI number for Syreeta Peacock is 1063012045. It was assigned to this individual provider in the NPPES registry on October 28, 2020.

Q: What is Syreeta Peacock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Syreeta Peacock was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 28, 2020

119 E DAYTON YELLOW SPRINGS RD, FAIRBORN, OH 45324(937) 754-0528 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 7, 2025, Oct 28, 2020 (2 updates tracked since 2020).

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About Syreeta A Peacock NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SYREETA A PEACOCK (NPI 1063012045) is an individual addiction (substance use disorder) provider in Fairborn, Ohio, licensed in Ohio (CDCA.178947) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1063012045

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameSYREETA A PEACOCK

Location Address119 E DAYTON YELLOW SPRINGS RDFairborn, OH 45324-3446

Mailing Address119 E Dayton Yellow Springs RdFairborn, OH 45324-3446 · (937) 754-0528

Phone(937) 754-0528

Sole ProprietorNo

Enumeration DateOctober 28, 2020

Last NPPES UpdateMay 7, 20252 updates tracked since enumeration

NPPES CertifiedMay 7, 2025

✔ NPI 1063012045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OH · CDCA.178947

119 E DAYTON YELLOW SPRINGS RD, Fairborn, OH 45324

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JORDAN REBECCA SHAVERS BA, CDCA

Counselor (Addiction (Substance Use Disorder))

119 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324

Greene County (937) 405-1743

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Syreeta Peacock's NPI number?

The NPI number for Syreeta Peacock is 1063012045. It was assigned to this individual provider in the NPPES registry on October 28, 2020.

Where is Syreeta Peacock located?

Syreeta Peacock practices at 119 E Dayton Yellow Springs Rd, Fairborn, OH 45324. The listed phone number is (937) 754-0528.

What is Syreeta Peacock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Syreeta Peacock was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.