Provider Demographics
NPI:1043429889
Name:PEARLMAN, JOY DEBRA (LCSW LICENSED CLINIC)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:DEBRA
Last Name:PEARLMAN
Suffix:
Gender:F
Credentials:LCSW LICENSED CLINIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 FORDS LN
Mailing Address - Street 2:APT D
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2916
Mailing Address - Country:US
Mailing Address - Phone:410-764-2776
Mailing Address - Fax:
Practice Address - Street 1:3602 FORDS LN
Practice Address - Street 2:APT D
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2916
Practice Address - Country:US
Practice Address - Phone:410-764-2776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132841041C0700X
CALCS 208501041C0700X
NYR07187211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW20850Medicare ID - Type Unspecified