Healthcare Provider Details

I. General information

NPI: 1558061556
Provider Name (Legal Business Name): RAELYN PEARSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 SHERIDAN BLVD STE 302C
WESTMINSTER CO
80003-6405
US

IV. Provider business mailing address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 720-588-2014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09931968
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07256
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: