Provider Demographics
NPI:1336562123
Name:PEARSON, NEAL
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:PEARSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BEAL ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1540
Mailing Address - Country:US
Mailing Address - Phone:781-556-5172
Mailing Address - Fax:781-749-3873
Practice Address - Street 1:100 BEAL ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1540
Practice Address - Country:US
Practice Address - Phone:781-556-5172
Practice Address - Fax:781-749-3873
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health