Provider Demographics
NPI:1023238607
Name:PEARSON, ALICE BECKETT (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:BECKETT
Last Name:PEARSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9154 DAYTONA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-2905
Mailing Address - Country:US
Mailing Address - Phone:850-458-0093
Mailing Address - Fax:
Practice Address - Street 1:151 ELLYSON AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-5239
Practice Address - Country:US
Practice Address - Phone:850-452-5990
Practice Address - Fax:850-452-2586
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8904081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical