Provider Demographics
NPI:1164844437
Name:PEARLMAN, SHOSHANA BETH
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:BETH
Last Name:PEARLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHOSHANA
Other - Middle Name:BETH
Other - Last Name:LEHRHAUPT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6123 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4860
Mailing Address - Country:US
Mailing Address - Phone:301-881-3700
Mailing Address - Fax:301-770-8741
Practice Address - Street 1:6260 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4119
Practice Address - Country:US
Practice Address - Phone:917-446-5107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical