Renita Pearson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6 Denny Rd Ste 104
Wilmington, DE 19809-3444

Phone

(302) 543-5089

Fax

(302) 397-8279

NPI assigned

Jul 19, 2021

Sex

Female

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

Other names 1

• NA NA Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Aviva Health Services Inc

  • Clinic/Center
  • Wilmington, DE
  • NPI 1891307070
  NPD

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1679146591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 STONEBRIDGE BLVD",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197206706",
            "telephone_number": "302-379-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DENNY RD STE 104",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093444",
            "telephone_number": "302-543-5089",
            "fax_number": "302-397-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "RENITA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "NA",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NA",
            "last_name": "NA",
            "credential": "NA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Elizabeth Pearce, LCSW
• Pearl Luxe RX
• Anteyzeha Leea Pearsall
• Lauren Marie Pearson
• Loren Pearson, PSY
• Tania Pearson
• Tracy Pearson, LCSW
• Pecos T. Olurin MD, PA
• Caitlin Rose Pedersen-Brown, MD
• Pedirite Medical de LLC

• Addiction (Substance Use Disorder) Counselor in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Addiction (Substance Use Disorder) Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.