Provider Demographics
NPI:1417304783
Name:PITMAN, SETH REMINGTON (MA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:REMINGTON
Last Name:PITMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE AUSTEN RIGGS CENTER
Mailing Address - Street 2:PO BOX 962
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0962
Mailing Address - Country:US
Mailing Address - Phone:413-931-5843
Mailing Address - Fax:
Practice Address - Street 1:AUSTEN RIGGS CENTER
Practice Address - Street 2:25 MAIN STREET
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01261
Practice Address - Country:US
Practice Address - Phone:413-931-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10992103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical