Provider Demographics
NPI:1245227750
Name:PEARLSTEIN, LESTER S (PHD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:S
Last Name:PEARLSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 TASMANIA DR
Mailing Address - Street 2:
Mailing Address - City:FREE UNION
Mailing Address - State:VA
Mailing Address - Zip Code:22940-1939
Mailing Address - Country:US
Mailing Address - Phone:434-973-3835
Mailing Address - Fax:
Practice Address - Street 1:100 E SOUTH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5217
Practice Address - Country:US
Practice Address - Phone:434-971-4747
Practice Address - Fax:434-293-4690
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000882103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
680000052Medicare ID - Type Unspecified