Provider Demographics
NPI:1639210099
Name:PEARMAIN-HOVESTADT, ELISSA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ELISSA
Middle Name:
Last Name:PEARMAIN-HOVESTADT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WHITE POND ROAD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3217
Mailing Address - Country:US
Mailing Address - Phone:781-259-0492
Mailing Address - Fax:
Practice Address - Street 1:336 BAKER AVENUE
Practice Address - Street 2:SUITE 108
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742
Practice Address - Country:US
Practice Address - Phone:978-369-1113
Practice Address - Fax:978-369-0908
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5465101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA339320OtherTRICARE
MALMG085OtherBCBS