Individual
JACOB TAGE PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
1836 VICTORIA LN, CHARLESTON, IL 61920-2964
(217) 508-8080
Mailing address
1836 VICTORIA LN, CHARLESTON, IL 61920-2964
(217) 508-8080
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
178019855
IL
Other
Enumeration date
09/01/2023
Last updated
03/11/2026
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