Healthcare Provider Details

I. General information

NPI: 1992565162
Provider Name (Legal Business Name): PEARL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 SUTTON AVE
REEDVILLE VA
22539-4413
US

IV. Provider business mailing address

220 SUTTON AVE
REEDVILLE VA
22539-4413
US

V. Phone/Fax

Practice location:
  • Phone: 804-832-8647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SARAH MCCARTHY
Title or Position: OWNER
Credential: LPC
Phone: 804-832-8647