Provider Demographics
NPI:1891093993
Name:PITTMAN CONSULTING & PROFESSION SERVICES, PLLC
Entity Type:Organization
Organization Name:PITTMAN CONSULTING & PROFESSION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPCS, LLAS
Authorized Official - Phone:336-692-5143
Mailing Address - Street 1:2574 GRIFFITH MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103
Mailing Address - Country:US
Mailing Address - Phone:336-692-5143
Mailing Address - Fax:336-448-5723
Practice Address - Street 1:8011 NORTH POINT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106
Practice Address - Country:US
Practice Address - Phone:336-692-5143
Practice Address - Fax:336-448-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty