Provider Demographics
NPI:1083463400
Name:BOBBY-TASIE, PEARL EBUBECHUKWU (LCSW-A)
Entity type:Individual
Prefix:MS
First Name:PEARL
Middle Name:EBUBECHUKWU
Last Name:BOBBY-TASIE
Suffix:
Gender:
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CONSULTANT PL STE 100B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3598
Mailing Address - Country:US
Mailing Address - Phone:919-228-8455
Mailing Address - Fax:
Practice Address - Street 1:6 CONSULTANT PL STE 100B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3598
Practice Address - Country:US
Practice Address - Phone:919-228-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical