Pearls of Wisdom Psychiatric

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PEARLS OF WISDOM PSYCHIATRIC

Doing business as

Pearls Of Wisdom Psychiatric

Practice address

5295 Oberlin Ave Ste a
Lorain, OH 44053-3454

Phone

(440) 444-1395

NPI assigned

Aug 2, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Pamela Denise Pardon, PMHNP-BCNPI 1730425356

Title

RN MSN

Phone

(440) 444-1395

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pearls Of Wisdom Psychiatric Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Denise Pardon, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lorain, OH
  • NPI 1730425356
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1306491774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5295 OBERLIN AVE STE A",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533454",
            "telephone_number": "440-444-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 OBERLIN AVE STE A",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533454",
            "telephone_number": "440-444-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLS OF WISDOM PSYCHIATRIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "PARDON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "RN MSN",
        "authorized_official_telephone_number": "440-444-1395",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133139",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearls Of Wisdom Psychiatric",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul J Alton OD Inc
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• Alyssa Nichole Peebles
• Tiffany M Peery, LPCC-S
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• Christopher G Pejoro
• Lauren Elizabeth Pekar, DPM

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lorain, OH
• Providers in Lorain, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.