Provider Demographics
NPI:1184958845
Name:PEARSON, SARAH ELAINE (MED)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELAINE
Other - Last Name:LINCOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 WALLER AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-271-9448
Mailing Address - Fax:
Practice Address - Street 1:343 WALLER AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-271-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker