Provider Demographics
NPI:1801943873
Name:PEARSON, ELLEN
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:MA
Mailing Address - Zip Code:01245-0264
Mailing Address - Country:US
Mailing Address - Phone:413-528-1988
Mailing Address - Fax:
Practice Address - Street 1:60 COTTAGE ST
Practice Address - Street 2:MAIN ST HUMAN RESOURCES BRIEN CENTER
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1302
Practice Address - Country:US
Practice Address - Phone:413-528-9156
Practice Address - Fax:413-528-8187
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor