Provider Demographics
NPI:1083996631
Name:PEARSON, ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:29 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4729
Mailing Address - Country:US
Mailing Address - Phone:603-444-5358
Mailing Address - Fax:603-444-0145
Practice Address - Street 1:29 MAPLE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4729
Practice Address - Country:US
Practice Address - Phone:802-323-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01342491041C0700X
MELC83791041C0700X
NH23631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical