Provider Demographics
NPI:1295405496
Name:PEARCE, ANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:641 BRIAN CIR
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1627
Mailing Address - Country:US
Mailing Address - Phone:505-480-2726
Mailing Address - Fax:
Practice Address - Street 1:4 9TH AVE STE F
Practice Address - Street 2:
Practice Address - City:SHALIMAR
Practice Address - State:FL
Practice Address - Zip Code:32579-1742
Practice Address - Country:US
Practice Address - Phone:850-290-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW16854101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)