Provider Demographics
NPI:1093136699
Name:PEARL, JOANNE (LMSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:PEARL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4119 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3034
Mailing Address - Country:US
Mailing Address - Phone:718-652-0227
Mailing Address - Fax:718-652-9275
Practice Address - Street 1:4119 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3034
Practice Address - Country:US
Practice Address - Phone:718-652-0227
Practice Address - Fax:718-652-9275
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083474104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker