Provider Demographics
NPI:1992919088
Name:PEARSON, ALANA SUE (CTA)
Entity type:Individual
Prefix:MR
First Name:ALANA
Middle Name:SUE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:CTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1565
Mailing Address - Country:US
Mailing Address - Phone:402-336-4841
Mailing Address - Fax:402-336-4640
Practice Address - Street 1:118 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1565
Practice Address - Country:US
Practice Address - Phone:402-336-4841
Practice Address - Fax:402-336-4640
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025001800Medicaid