William Clay Pearson, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0088461 Issued in NM

Practice address

211 W Mesa Ave
Suite #4
Gallup, NM 87301-6382

Phone

(505) 862-9992

Fax

(505) 862-9992

NPI assigned

May 8, 2007

Last updated

Jun 3, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Synergy Behavioral Health Center, P.C.

  • Community/Behavioral Health Agency
  • Gallup, NM
  • NPI 1629495296
  NPD (past) Authorized official

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1417160987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3579",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873053579",
            "telephone_number": "505-862-9992",
            "fax_number": "505-862-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W MESA AVE",
            "address_2": "SUITE #4",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016382",
            "telephone_number": "505-862-9992",
            "fax_number": "505-862-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "WILLIAM",
        "middle_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "4206",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0088461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58475532",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin R Paul, RN
• Nicole Aline Pavy, RN
• Jason Frank Pawlowski
• Jean Payton
• Peak Medical Gallup, LLC (McKinley Center)
• Viola R Peina
• Regine Francine Penda Ewanga
• Alicia Marie Pender, RN
• Melissa Penn, CNM
• Kevin Dale Perdue, M.D.

• Mental Health Counselor in Gallup, NM
• Providers in Gallup, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.