Pearson, Kenneth

Pearson, Kenneth is an individual health care provider with primary practice located at 1703 Country Club Rd Suite 204, Jacksonville NC 28546. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Pearson, Kenneth can be contacted via phone (910) 347-3010.

Contact Information

Primary practice address
1703 Country Club Rd Suite 204 Jacksonville NC 28546
Phone: (910) 347-3010
Fax: (910) 347-3201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2269 North Carolina

Profile Details

NPI number 1376521252
LBN Legal business name Pearson, Kenneth
Credentials LPA
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated May 8th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376521252 NPPES
North Carolina Other 141U1 BC/BS
North Carolina MEDICAID 6107133 BC/BS

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