Cordell Pearson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC19817 Issued in AZ

Practice address

10149 N 92ND St Ste 103
Scottsdale, AZ 85258-4557

Phone

(480) 256-9799

NPI assigned

Apr 5, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 15, 2024 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1174102537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 W BENTRUP ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241002",
            "telephone_number": "480-256-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10149 N 92ND ST STE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584557",
            "telephone_number": "480-256-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "CORDELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC17606",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC19817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peapod Pediatrics PLLC
• Ernesta Pearl
• Leslie Pearl, CRNA
• Pearls 32 PLLC
• Aaron Nicholas Pearse, PHARMD
• Kelly Cathryn Pearson, M.D.
• Margaret A Pearson, MD
• Malorie Jeanne Pease, DPT
• Matthew William Pecora, DPT
• Sarah Pecorelli, MS, OTD

• Mental Health Counselor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.