Provider Demographics
NPI:1558898999
Name:PITTS, IKEA MONIQUE (LPC)
Entity Type:Individual
Prefix:MS
First Name:IKEA
Middle Name:MONIQUE
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 1:206 JILL LN APT 104
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2132
Mailing Address - Country:US
Mailing Address - Phone:215-888-6498
Mailing Address - Fax:
Practice Address - Street 1:216 MICHIGAN AVE NE STE 125
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1095
Practice Address - Country:US
Practice Address - Phone:202-877-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional