Provider Demographics
NPI:1558836056
Name:ADULT & PEDIATRIC COUNSELING SPECIALISTS PLLC
Entity Type:Organization
Organization Name:ADULT & PEDIATRIC COUNSELING SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:475-323-2200
Mailing Address - Street 1:153 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2791
Mailing Address - Country:US
Mailing Address - Phone:475-323-2200
Mailing Address - Fax:475-323-2201
Practice Address - Street 1:153 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2791
Practice Address - Country:US
Practice Address - Phone:203-350-0866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty