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General NPI Number Information
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NPI Number | 1174693717
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Entity Type | Individual
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Provider Name | RENEE PEARSON MSW, LCSW, LCAS
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 102 REGENCY BLVD STE B5
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City | GREENVILLE
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State | NC
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Zip | 27834-4666
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Country | US
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Telephone | 252-355-5587
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Fax | 252-355-0388
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Provider Business Mailing Address
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Address Line | PO BOX 3843
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City | GREENVILLE
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State | NC
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Zip | 27836-1843
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Country | US
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Telephone | 252-355-5587
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Fax | 252-355-0388
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C003884
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License Number State | NC
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