Provider Demographics
NPI:1568123636
Name:MILLICENT PITTS-LICENSED MARRIAGE & FAMILY THERAPIST
Entity Type:Organization
Organization Name:MILLICENT PITTS-LICENSED MARRIAGE & FAMILY THERAPIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILLICENT
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-748-1633
Mailing Address - Street 1:1430 TRUXTUN AVE STE 720
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5220
Mailing Address - Country:US
Mailing Address - Phone:661-717-6775
Mailing Address - Fax:866-812-6912
Practice Address - Street 1:1430 TRUXTUN AVE STE 720
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5220
Practice Address - Country:US
Practice Address - Phone:661-717-6775
Practice Address - Fax:866-812-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-31
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093836736Medicaid