Provider Demographics
NPI:1235642406
Name:PITTS, LATRICIA (LPC)
Entity Type:Individual
Prefix:
First Name:LATRICIA
Middle Name:
Last Name:PITTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2873 DEMOONEY RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1123
Mailing Address - Country:US
Mailing Address - Phone:404-913-2033
Mailing Address - Fax:404-941-7556
Practice Address - Street 1:5835 CAMPBELLTON RD SW STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8014
Practice Address - Country:US
Practice Address - Phone:404-913-2033
Practice Address - Fax:404-941-7556
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008520101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional