Provider Demographics
NPI:1811273246
Name:PEARSON, JENNIFER N (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:PEARSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 FERNWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2116
Mailing Address - Country:US
Mailing Address - Phone:407-875-3700
Mailing Address - Fax:407-667-1626
Practice Address - Street 1:237 FERNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2116
Practice Address - Country:US
Practice Address - Phone:407-875-3700
Practice Address - Fax:407-667-1626
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW135441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical