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NPI Code Detail

MEDICARE: DENNIS PEARSON LPC, CADC

MEDICARE: DENNIS PEARSON LPC, CADC
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
1101YM0800XMental Health Counselor178.009166IL

General Provider Information

NPI Number : 1891280970
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS PEARSON LPC, CADC
Provider Business Mailing Address
First Line : 1836 VICTORIA LN
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-2964
Country : US
Telephone Number : 217-508-7953
Fax Number :
Provider Business Practice Location Address
First Line : 1836 VICTORIA LN
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-2964
Country : US
Telephone Number : 217-508-7953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2018
Last Update Date : 06/29/2018

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Directions to “ DENNIS PEARSON LPC, CADC” Practice Location

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