Individual
MR. KIMBER CHARLES PEARCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, LCAS, CRC
Contact information
Practice address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
(910) 938-1118
Mailing address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
(910) 938-1118
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1297
NC
101YM0800X
Mental Health Counselor
7036
NC
101YP2500X
Professional Counselor
Primary
7036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1525J
BLUE CROSS BLUE SHIELD
NC
01
—
444429
TRICARE MHN
NC
05
—
6103995
—
NC
Enumeration date
08/06/2008
Last updated
04/04/2013
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