| Jesse Pearlstein Llc | |
|
5821 Staples Mill Rd Henrico VA 23228-5427 | |
| (804) 264-0966 | |
| Not Available |
| Full Name | Jesse Pearlstein Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5821 Staples Mill Rd, Henrico, Virginia |
| Authorized Official Name and Position | Jesse Gray Pearlstein (OWNER) |
| Authorized Official Contact | 8044043659 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse Pearlstein Llc 937 Bradley Ln Richmond VA 23225-4305 Ph: (434) 906-5299 | Jesse Pearlstein Llc 5821 Staples Mill Rd Henrico VA 23228-5427 Ph: (804) 264-0966 |
| NPI Number | 1609415488 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Medicare PECOS PAC ID | 2264853514 |
|---|---|
| Medicare Enrollment ID | O20200522001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609415488 | NPI | - | NPPES |
| 1831636950 | Other | VA | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jesse Pearlstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831636950 PECOS PAC ID: 6608143474 Enrollment ID: I20170526000466 |
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