Provider Demographics
NPI:1487752549
Name:PIERSON, JAMES DAVID (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DAVID
Last Name:PIERSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 1/2 EAST 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101
Mailing Address - Country:US
Mailing Address - Phone:270-779-9425
Mailing Address - Fax:270-842-9158
Practice Address - Street 1:418 1/2 EAST 10TH STREET
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101
Practice Address - Country:US
Practice Address - Phone:270-779-9425
Practice Address - Fax:270-842-9158
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical