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General NPI Number Information
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NPI Number | 1043999089
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Entity Type | Individual
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Provider Name | AUSTIN GARRETT PEARCE M.ED, LCMHC-A
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Gender | Male
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 936 NORTHBROOK DR
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City | RALEIGH
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State | NC
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Zip | 27609-5518
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Country | US
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Telephone | 919-701-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 4375 GODWIN LAKE RD
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City | BENSON
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State | NC
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Zip | 27504-6339
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Country | US
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Telephone | 919-602-9212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A18944
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License Number State | NC
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