Provider Demographics
NPI:1134499122
Name:PIZZITOLA, JARED (MED, LPC)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:PIZZITOLA
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:SUITE 313
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4064
Mailing Address - Country:US
Mailing Address - Phone:281-846-4787
Mailing Address - Fax:832-886-2860
Practice Address - Street 1:54 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:SUITE 313
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4064
Practice Address - Country:US
Practice Address - Phone:281-846-4787
Practice Address - Fax:832-886-2860
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional