Provider Demographics
NPI:1144390485
Name:PITT, MARIE (MSW LCSW LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:PITT
Suffix:
Gender:F
Credentials:MSW LCSW LMFT
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:WOMACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:#6 ELM RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7432
Mailing Address - Country:US
Mailing Address - Phone:609-466-1766
Mailing Address - Fax:609-466-0566
Practice Address - Street 1:#6 ELM RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7432
Practice Address - Country:US
Practice Address - Phone:609-466-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000271001041C0700X
NJ37F100077800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5956048OtherMAGELLAN AETNA
105005OtherMANGD HLTH NETWK
5956048OtherMAGELLAN AETNA