Provider Demographics
NPI:1922646603
Name:PEARSON, ERNEST (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:PEARSON
Suffix:
Gender:M
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1543
Mailing Address - Country:US
Mailing Address - Phone:267-481-5805
Mailing Address - Fax:
Practice Address - Street 1:1001 STERIGERE ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-5300
Practice Address - Country:US
Practice Address - Phone:610-313-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9969101YA0400X
PAPC010047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)