Healthcare Provider Details

I. General information

NPI: 1841423589
Provider Name (Legal Business Name): ADAM PEARSON L.C.P.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 PYRAMID LN
CREAL SPRINGS IL
62922-1429
US

IV. Provider business mailing address

590 PYRAMID LN
CREAL SPRINGS IL
62922-1429
US

V. Phone/Fax

Practice location:
  • Phone: 270-217-8888
  • Fax:
Mailing address:
  • Phone: 270-217-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7791-125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2017009346
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12760694-6004
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0897
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180015845
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180015845
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0013735
License Number StateCO
# 8
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097651
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: