Provider Demographics
NPI:1881955409
Name:PEARSON, DAVID STEWART (LCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:STEWART
Last Name:PEARSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 NEW CASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BELVEDERE
Mailing Address - State:SC
Mailing Address - Zip Code:29841-2633
Mailing Address - Country:US
Mailing Address - Phone:803-278-6919
Mailing Address - Fax:
Practice Address - Street 1:2052 GORDON HWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-5427
Practice Address - Country:US
Practice Address - Phone:706-955-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0046951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical