Provider Demographics
NPI:1073063061
Name:PEARMAN, COLLIN JEREMIAH (LPC)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:JEREMIAH
Last Name:PEARMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 STATE LINE RD.
Mailing Address - Street 2:STE. 220 #772
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2025
Mailing Address - Country:US
Mailing Address - Phone:913-730-5700
Mailing Address - Fax:
Practice Address - Street 1:8301 STATE LINE RD.
Practice Address - Street 2:STE. 220 #772
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2025
Practice Address - Country:US
Practice Address - Phone:913-730-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022014611101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional