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General NPI Number Information
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NPI Number | 1386034155
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Entity Type | Individual
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Provider Name | JAMES PEARSON LCSW, CSAC
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Gender | Male
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 855 COMMUNITY DR
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City | SAUK CITY
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State | WI
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Zip | 53583-1380
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Country | US
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Telephone | 224-404-0635
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42
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City | PRAIRIE DU SAC
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State | WI
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Zip | 53578-0042
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15822-132
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8531-123
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 129335-121
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License Number State | WI
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