Provider Demographics
NPI:1700974599
Name:PEARSON, SHARON LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1902
Mailing Address - Country:US
Mailing Address - Phone:614-486-1986
Mailing Address - Fax:614-486-2410
Practice Address - Street 1:1943 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1902
Practice Address - Country:US
Practice Address - Phone:614-486-1986
Practice Address - Fax:614-486-2410
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4104103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical