Provider Demographics
NPI:1972831824
Name:PITSIOS, MEGAN KATRINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KATRINA
Last Name:PITSIOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:KATRINA
Other - Last Name:PITSIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3827 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3935
Mailing Address - Country:US
Mailing Address - Phone:626-727-8462
Mailing Address - Fax:
Practice Address - Street 1:3827 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3935
Practice Address - Country:US
Practice Address - Phone:626-727-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 316541041C0700X
CAASW31654104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31654OtherBBS ASW REGISTRATION
CA71781OtherBBS LCSW