Provider Demographics
NPI:1588078349
Name:PEARSON, TRISHA MONIQUE (LPC)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:MONIQUE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CONCORD BLVD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-9642
Mailing Address - Country:US
Mailing Address - Phone:215-990-8117
Mailing Address - Fax:
Practice Address - Street 1:200 JENKINTOWN COMMONS
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-885-3337
Practice Address - Fax:215-885-3090
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA173-025-9904101YM0800X
PAPC007595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty