Provider Demographics
NPI:1447424312
Name:PEARSON, DAVID ORRIN (MA, LPC, LAT, CCHT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ORRIN
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MA, LPC, LAT, CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6468
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-1868
Mailing Address - Country:US
Mailing Address - Phone:307-752-5435
Mailing Address - Fax:307-448-4800
Practice Address - Street 1:1949 SUGARLAND DR STE 160
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5764
Practice Address - Country:US
Practice Address - Phone:307-752-5435
Practice Address - Fax:307-448-4800
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY289101YA0400X
WY413101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)