Wayne Preston Pearson Jr., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122230 Issued in MA

Practice address

75 Kneeland St
Boston, MA 02111-1901

Phone

(617) 457-8140

NPI assigned

Nov 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

DC Care Collaborative LLCGroup PAC ID 6002215928, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• DC Care Collaborative, LLC

  • Clinical Social Worker
  • Washington, DC
  • NPI 1477130300
  Medicare reassignment Care Compare group
• Whitman-Walker Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1184616617
  Medicare reassignment NPD
• Whitman-Walker Clinic Inc.

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1003316316
  NPD
• Whitman-Walker Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1821113341
  NPD (past)

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1811531965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111901",
            "telephone_number": "617-457-8140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Kneeland St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111901",
            "country_code": "US",
            "telephone_number": "617-457-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "WAYNE",
        "middle_name": "PRESTON",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Curtis Pearson, PHARMD
• Kimberly Hope Pearson, MD
• Riley Pearson
• Stephanie Pearson
• Steven D Pearson, M.D.
• Leah Peavey, PA-C
• Diane Griffiths Peck, CNM
• Jacquelin Peck, M.D.
• Katherine Mohr Peck, BSN, MSN, FNP
• Robert N Peck, M.D.

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.