Provider Demographics
NPI:1053384131
Name:PIERSON, MARSHALL J III (LPCC)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:J
Last Name:PIERSON
Suffix:III
Gender:M
Credentials:LPCC
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 817
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43357-0817
Mailing Address - Country:US
Mailing Address - Phone:937-465-8065
Mailing Address - Fax:937-465-3505
Practice Address - Street 1:1521 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:OH
Practice Address - Zip Code:43357-0817
Practice Address - Country:US
Practice Address - Phone:937-465-8065
Practice Address - Fax:937-465-3505
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0007302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional