Kayla Ann Pearson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1490411452 Issued in IL

Practice address

410 S Pine St
Centralia, IL 62801-4028

Phone

(618) 816-2419

NPI assigned

Jul 11, 2022

Last updated

Sep 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kayla Ann Pearson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1487388906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S PINE ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628014028",
            "telephone_number": "618-816-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S PINE ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628014028",
            "telephone_number": "618-816-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "1490411452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "PEARSON",
            "middle_name": "ANN",
            "credential": "KAYLA PEARSON, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mallory Owens, MSW
• Lyle D Pahnke Jr., MD
• Suchi Paris Lineberry, LCSW
• Brooke Felena Payne
• Dale D Pearce, APRN, FNP-C
• Pediatric Group, LLC
• Penta Group Inc.
• Penta Nascent Corporation (Diamondview)
• Penta Nascent Corporation (Park Place)
• Penta Nascent Corporation (Colonial Apts.)

• Clinical Social Worker in Centralia, IL
• Providers in Centralia, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.