Healthcare Provider Details

I. General information

NPI: 1265795512
Provider Name (Legal Business Name): BRENDA PEARSON M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 WOODDALE BLVD
BATON ROUGE LA
70805-7567
US

IV. Provider business mailing address

PO BOX 66558
BATON ROUGE LA
70896-6558
US

V. Phone/Fax

Practice location:
  • Phone: 225-925-1906
  • Fax: 855-473-0115
Mailing address:
  • Phone: 225-922-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4709
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4709
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: