Provider Demographics
NPI:1831499474
Name:PEARLSTEIN, BRENDA LOIS
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:LOIS
Last Name:PEARLSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2407
Mailing Address - Country:US
Mailing Address - Phone:508-753-6263
Mailing Address - Fax:508-757-0543
Practice Address - Street 1:104 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2407
Practice Address - Country:US
Practice Address - Phone:508-753-6263
Practice Address - Fax:508-757-0543
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health