Provider Demographics
NPI:1679686414
Name:PEARLMAN, NATHAN EDWARD (LPC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:EDWARD
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5725
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-5725
Mailing Address - Country:US
Mailing Address - Phone:903-334-8022
Mailing Address - Fax:903-334-7019
Practice Address - Street 1:4425 JEFFERSON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1535
Practice Address - Country:US
Practice Address - Phone:870-216-1700
Practice Address - Fax:870-772-5965
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12091101YM0800X
ARP9508019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health