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NPI Code Detail

MEDICARE: WILLIAM J PEARL LCSW, LPC

MEDICARE: WILLIAM J PEARL LCSW, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerCP00455139WV
2101YP2500XProfessional Counselor199WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000145928OTHERWVMOUNTAIN STATE BCBS
2172723OTHERWVTRICARE
32070075OTHERWVCIGNA
4Y141569OTHERWVHEALTH PLAN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6243490000OTHERWVMAGELLAN MIS NUMBER

General Provider Information

NPI Number : 1538228770
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM J PEARL LCSW, LPC
Provider Business Mailing Address
First Line : 501 COLLIERS WAY
Second Line :
City : WEIRTON
State : WV
Zip : 26062-5003
Country : US
Telephone Number : 304-723-5440
Fax Number : 304-723-0665
Provider Business Practice Location Address
First Line : 501 COLLIERS WAY
Second Line :
City : WEIRTON
State : WV
Zip : 26062-5003
Country : US
Telephone Number : 304-723-5440
Fax Number : 304-723-0665
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 05/26/2010

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