Provider Demographics
NPI:1164098554
Name:PITTS, COURTNEY MELISSA
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MELISSA
Last Name:PITTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24008 CRAB APPLE CT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2404
Mailing Address - Country:US
Mailing Address - Phone:270-792-5042
Mailing Address - Fax:
Practice Address - Street 1:900 HEALTH SERVICES DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5786
Practice Address - Country:US
Practice Address - Phone:302-262-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health