Provider Demographics
NPI:1407966286
Name:PETTIT, JAMES L (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:PETTIT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 DOUGLAS AVE STE 777
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5938
Mailing Address - Country:US
Mailing Address - Phone:214-538-2788
Mailing Address - Fax:
Practice Address - Street 1:8222 DOUGLAS AVE STE 777
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5938
Practice Address - Country:US
Practice Address - Phone:214-538-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor