Provider Demographics
NPI:1386704005
Name:PEARCE, REBECCA J (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:PEARCE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17150 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9290
Mailing Address - Country:US
Mailing Address - Phone:503-668-5001
Mailing Address - Fax:503-388-3162
Practice Address - Street 1:17150 UNIVERSITY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-9290
Practice Address - Country:US
Practice Address - Phone:503-668-5001
Practice Address - Fax:503-388-3162
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 106H00000X
WALH 60108339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health