Provider Demographics
NPI:1679198923
Name:PITTS, TERRY KEVIN (LPC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:KEVIN
Last Name:PITTS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HARTLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-1258
Mailing Address - Country:US
Mailing Address - Phone:864-414-6850
Mailing Address - Fax:
Practice Address - Street 1:245 HARTLEIGH DR
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1258
Practice Address - Country:US
Practice Address - Phone:864-414-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4868101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health