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Contact Information

KENNETH PEARSON, LPA
1703 COUNTRY CLUB RD
SUITE 204
JACKSONVILLE, NC28546
 Phone: 910-347-3010
 Fax: 910-347-3201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KENNETH PEARSON · (Male)

NPI Number 1376521252
Status Active
Credentials LPA
Entity Individual
Enumeration date 01/03/2006
Last updated 05/08/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 2269
  • NC Medicaid 6107133
  • NC Other 141U1 BC/BS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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