Healthcare Provider Details

I. General information

NPI: 1629448220
Provider Name (Legal Business Name): STEPHANIE PEARCE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2334 ROUTE 209
SCIOTA PA
18354-7734
US

IV. Provider business mailing address

725 OVERVIEW TER
EFFORT PA
18330-8021
US

V. Phone/Fax

Practice location:
  • Phone: 908-300-1163
  • Fax: 855-507-9439
Mailing address:
  • Phone: 908-300-1163
  • Fax: 855-507-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018207
License Number StatePA

VIII. Authorized Official

Name: STEPHANIE PEARCE
Title or Position: OWNER/THERAPIST
Credential:
Phone: 908-300-1163