Provider Demographics
NPI:1801828223
Name:PEARL, DEBRA R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:R
Last Name:PEARL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12141 LADUE RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8120
Mailing Address - Country:US
Mailing Address - Phone:314-878-4340
Mailing Address - Fax:314-878-4524
Practice Address - Street 1:12141 LADUE RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8120
Practice Address - Country:US
Practice Address - Phone:314-878-4340
Practice Address - Fax:314-878-4524
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040240331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical