Provider Demographics
NPI:1396894820
Name:PAPPAS, PEARL E (LCSW)
Entity type:Individual
Prefix:MS
First Name:PEARL
Middle Name:E
Last Name:PAPPAS
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 1:48 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06783-1614
Mailing Address - Country:US
Mailing Address - Phone:860-354-8059
Mailing Address - Fax:
Practice Address - Street 1:20 GERMANTOWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5023
Practice Address - Country:US
Practice Address - Phone:203-748-1200
Practice Address - Fax:203-790-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0004341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical