Provider Demographics
NPI:1346253044
Name:PITTMAN, BETTY A (LPC NCC)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:A
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:GA
Mailing Address - Zip Code:30205
Mailing Address - Country:US
Mailing Address - Phone:770-719-0599
Mailing Address - Fax:770-631-3407
Practice Address - Street 1:14 EASTBROOK BEND
Practice Address - Street 2:SUITE 203
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:770-719-0599
Practice Address - Fax:770-631-3407
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional