Provider Demographics
NPI:1124744925
Name:PEARSON, SOPHIA RUTH MAE (MSW,LSW)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:RUTH MAE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34950 CHARDON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9162
Mailing Address - Country:US
Mailing Address - Phone:440-299-7829
Mailing Address - Fax:954-208-9777
Practice Address - Street 1:34950 CHARDON RD STE 210
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9162
Practice Address - Country:US
Practice Address - Phone:440-299-7829
Practice Address - Fax:954-208-9777
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.22077911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical