Healthcare Provider Details

I. General information

NPI: 1033805429
Provider Name (Legal Business Name): JASON A PEARCE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E HUNTLAND DR STE 320
AUSTIN TX
78752-3741
US

IV. Provider business mailing address

3201 MCCURDY ST
AUSTIN TX
78723-2905
US

V. Phone/Fax

Practice location:
  • Phone: 512-201-4501
  • Fax:
Mailing address:
  • Phone: 512-499-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number81515
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number81515
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: