Provider Demographics
NPI:1528559044
Name:PITTS, DANA RACHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:RACHELLE
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 1:1104 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3701
Mailing Address - Country:US
Mailing Address - Phone:682-554-2906
Mailing Address - Fax:
Practice Address - Street 1:1104 ASPEN CT
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3701
Practice Address - Country:US
Practice Address - Phone:682-554-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional