Benjamin Pearson, LCSW

Individual provider Active NPI Clinical Social Worker · Midway, UT

NPI 1710219035 · NPPES record last updated Aug 6, 2014

Key facts

NPI
1710219035
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
533760601-3501 (UT)
Practice address
375 Rainbow LN
Midway, UT 84049-7001
Phone
(435) 654-1082
Fax
(435) 654-1485
NPI assigned
Feb 11, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
533760601-3501UTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 533760601-3501 UT Yes

Addresses

Primary practice location

375 Rainbow LN
Midway, UT 84049-7001

Mailing address

375 Rainbow Lane
PO Box 1000
Midway, UT 84049
Phone (435) 654-1082

Other providers in Midway, UT

All providers in Midway, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.