Provider Demographics
NPI:1174041891
Name:PEARCE, KATHLEEN D (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:D
Last Name:PEARCE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6203 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3906
Mailing Address - Country:US
Mailing Address - Phone:301-922-9247
Mailing Address - Fax:301-576-4430
Practice Address - Street 1:6203 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:301-922-9247
Practice Address - Fax:301-576-4430
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD186381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical