Provider Demographics
NPI:1346607033
Name:PITTS, RANISHA SHATORA
Entity Type:Individual
Prefix:
First Name:RANISHA
Middle Name:SHATORA
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 1:3255 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-4007
Mailing Address - Country:US
Mailing Address - Phone:941-429-0941
Mailing Address - Fax:
Practice Address - Street 1:1500 INDEPENDENCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2170
Practice Address - Country:US
Practice Address - Phone:941-359-1927
Practice Address - Fax:941-359-1929
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health