Provider Demographics
NPI:1730639386
Name:FITTES, BRADFORD (LPCC)
Entity Type:Individual
Prefix:
First Name:BRADFORD
Middle Name:
Last Name:FITTES
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 WINNETKA DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4226
Mailing Address - Country:US
Mailing Address - Phone:513-265-0091
Mailing Address - Fax:
Practice Address - Street 1:7577 CENTRAL PARKE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6806
Practice Address - Country:US
Practice Address - Phone:513-494-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0701092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health