Healthcare Provider Details

I. General information

NPI: 1659106946
Provider Name (Legal Business Name): EMILY RUTH PEARLSTEIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 E LOHMAN AVE STE 209
LAS CRUCES NM
88001-3172
US

IV. Provider business mailing address

6369 FRANKLIN GATE DR
EL PASO TX
79912-8166
US

V. Phone/Fax

Practice location:
  • Phone: 915-996-0088
  • Fax:
Mailing address:
  • Phone: 602-769-7120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0556
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: