Provider Demographics
NPI:1609114511
Name:PITTLEMAN, CARIN A (LCSW)
Entity Type:Individual
Prefix:
First Name:CARIN
Middle Name:A
Last Name:PITTLEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 N PORT WASHINGTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4927
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:262-789-1191
Practice Address - Street 1:1300 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2602
Practice Address - Country:US
Practice Address - Phone:414-390-5800
Practice Address - Fax:414-225-1340
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127763-1211041C0700X
WI8062-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical