Provider Demographics
NPI:1235377698
Name:PEARCE, MATTHEW CLARK (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CLARK
Last Name:PEARCE
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3473
Mailing Address - Country:US
Mailing Address - Phone:407-322-8018
Mailing Address - Fax:407-322-8575
Practice Address - Street 1:3525 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3473
Practice Address - Country:US
Practice Address - Phone:407-322-8018
Practice Address - Fax:407-322-8575
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW91371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical