Provider Demographics
NPI:1982785812
Name:PEARCE, REBECCA LYNNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNNE
Last Name:PEARCE
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 1:1410 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2804
Mailing Address - Country:US
Mailing Address - Phone:615-383-4300
Mailing Address - Fax:615-383-4352
Practice Address - Street 1:1410 17TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2804
Practice Address - Country:US
Practice Address - Phone:615-383-4300
Practice Address - Fax:615-383-4352
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3091444OtherBCBS
136841OtherVALUE OPTIONS
TN3688759Medicare ID - Type Unspecified