Provider Demographics
NPI:1306122064
Name:PEARSALL, KATHRYN GEARHEART (MS, LPC, RPT-S)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GEARHEART
Last Name:PEARSALL
Suffix:
Gender:F
Credentials:MS, LPC, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 N WASHINGTON HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1326
Mailing Address - Country:US
Mailing Address - Phone:804-305-5252
Mailing Address - Fax:
Practice Address - Street 1:14004 PROFFITT FARM RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2525
Practice Address - Country:US
Practice Address - Phone:804-305-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional