| Colleen M. Pearson Psyd Pllc | |
|
165 Broadway Fl 23 New York NY 10006-1452 | |
| (917) 725-4774 | |
| (917) 725-8676 |
| Full Name | Colleen M. Pearson Psyd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 165 Broadway Fl 23, New York, New York |
| Authorized Official Name and Position | Colleen Pearson (PSYCHOLOGIST) |
| Authorized Official Contact | 9179933975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen M. Pearson Psyd Pllc 630 Victory Blvd Apt 6e Staten Island NY 10301-3523 Ph: (917) 725-4774 | Colleen M. Pearson Psyd Pllc 165 Broadway Fl 23 New York NY 10006-1452 Ph: (917) 725-4774 |
| NPI Number | 1407308760 |
|---|---|
| Provider Enumeration Date | 11/02/2016 |
| Last Update Date | 06/22/2021 |
| Certification Date | 06/22/2021 |
| Medicare PECOS PAC ID | 5698056463 |
|---|---|
| Medicare Enrollment ID | O20211018002235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407308760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY8796 (Florida) | Primary |
| Provider Name | Colleen M. Pearson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013223874 PECOS PAC ID: 7517152473 Enrollment ID: I20181005002321 |
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