Provider Demographics
NPI:1184347791
Name:PEARSE, JENNIE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIE
Middle Name:
Last Name:PEARSE
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 1:71 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1434
Mailing Address - Country:US
Mailing Address - Phone:917-951-1451
Mailing Address - Fax:
Practice Address - Street 1:18 OLD POST RD S
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2316
Practice Address - Country:US
Practice Address - Phone:855-771-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117036104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker