Active NPI
Warren Jay Pearson, LCSW
- Clinical Social Worker
- Woodway, TX
National Provider Identifier
1306884127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 25384
- Practice address
- 345 Rainbow Dr
Woodway, TX 76712-3626 - Phone
- (254) 405-3364
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 25384 | TX | Primary |
Addresses
Primary practice location
345 Rainbow Dr
Woodway, TX 76712-3626
Mailing address
345 Rainbow Dr
Woodway, TX 76712-3626
Phone (254) 405-3364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25384 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1306884127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 RAINBOW DR",
"city": "WOODWAY",
"state": "TX",
"postal_code": "767123626",
"telephone_number": "254-405-3364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 RAINBOW DR",
"city": "WOODWAY",
"state": "TX",
"postal_code": "767123626",
"telephone_number": "254-405-3364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "WARREN",
"middle_name": "JAY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "25384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.