Provider Demographics
NPI:1730683434
Name:PEARCY, ANN MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:PEARCY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20992 E COUNTY ROAD 1420N
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-8366
Mailing Address - Country:US
Mailing Address - Phone:217-345-3001
Mailing Address - Fax:
Practice Address - Street 1:408 S 4TH ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3703
Practice Address - Country:US
Practice Address - Phone:217-347-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.002273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health