Provider Demographics
NPI:1558111401
Name:PITTMAN, BAILEY NICOLE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:NICOLE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:NICOLE
Other - Last Name:ESCHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-ASSOCIATE
Mailing Address - Street 1:2025 N HILL DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6217
Mailing Address - Country:US
Mailing Address - Phone:214-886-9075
Mailing Address - Fax:
Practice Address - Street 1:531 SILICON DR STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7561
Practice Address - Country:US
Practice Address - Phone:817-898-1746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health