Individual provider Active NPI

William J Pearl, LCSW, LPC

  • Social Worker
  • Weirton, WV
National Provider Identifier
1538228770
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CP00455139 Issued in WV
Practice address
501 Colliers Way
Weirton, WV 26062-5003
Phone
(304) 723-5440
Fax
(304) 723-0665
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CP00455139 WV Primary
Professional Counselor 101YP2500X 199 WV

Addresses

Primary practice location

501 Colliers Way
Weirton, WV 26062-5003

Mailing address

501 Colliers Way
Weirton, WV 26062-5003
Phone (304) 723-5440

Other identifiers 6

IdentifierTypeStateIssuer
000145928OtherWVMOUNTAIN STATE BCBS
172723OtherWVTRICARE
2070075OtherWVCIGNA
Y141569OtherWVHEALTH PLAN
0005456001MedicaidWV
243490000OtherWVMAGELLAN MIS NUMBER

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

LicenseStateTypeSpecialty
199WVMDProfessional Counselor
CP00455139WVMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1538228770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625003",
            "telephone_number": "304-723-5440",
            "fax_number": "304-723-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625003",
            "telephone_number": "304-723-5440",
            "fax_number": "304-723-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARL",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "LCSW, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "CP00455139",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "199",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "000145928",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "172723",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2070075",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "Y141569",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005456001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS NUMBER",
            "identifier": "243490000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.