Provider Demographics
NPI:1245490176
Name:PEARL, BELINDA ROSEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:ROSEANNE
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 1:565 UNION ST NE
Mailing Address - Street 2:#103
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2477
Mailing Address - Country:US
Mailing Address - Phone:503-585-0351
Mailing Address - Fax:
Practice Address - Street 1:565 UNION ST NE
Practice Address - Street 2:#103
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2477
Practice Address - Country:US
Practice Address - Phone:503-585-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR38281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical