Provider Demographics
NPI:1285725150
Name:PEARLMAN, MARILYN (LCSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:PEARLMAN
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:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-1054
Mailing Address - Country:US
Mailing Address - Phone:941-366-4411
Mailing Address - Fax:941-366-4641
Practice Address - Street 1:3293 FRUITVILLE RD UNIT 103
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6453
Practice Address - Country:US
Practice Address - Phone:941-366-4411
Practice Address - Fax:941-366-4411
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00039801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8566ZMedicare UPIN