Organization
JESSE PEARLSTEIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE GRAY PEARLSTEIN LCSW (OWNER)
(804) 404-3659
Entity
Organization
Contact information
Practice address
5821 STAPLES MILL RD, HENRICO, VA 23228-5427
(804) 264-0966
Mailing address
937 BRADLEY LN, RICHMOND, VA 23225-4305
(434) 906-5299
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831636950
PERSONAL NPI
VA
Enumeration date
12/27/2019
Last updated
12/27/2019
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