Healthcare Provider Details

I. General information

NPI: 1407352875
Provider Name (Legal Business Name): IAN JOSEPH PEARSON MA, BCBA, LABA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 JOSLIN ST SE
GRAND RAPIDS MI
49507-3309
US

IV. Provider business mailing address

941 JOSLIN ST SE
GRAND RAPIDS MI
49507-3309
US

V. Phone/Fax

Practice location:
  • Phone: 616-490-3534
  • Fax:
Mailing address:
  • Phone: 616-490-3534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-41869
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: