Provider Demographics
NPI:1184411407
Name:PITTOCK, TRAVIS ALLEN (MA, LPC, LSOTP)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:ALLEN
Last Name:PITTOCK
Suffix:
Gender:
Credentials:MA, LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 105TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-8101
Mailing Address - Country:US
Mailing Address - Phone:682-270-6340
Mailing Address - Fax:
Practice Address - Street 1:3905 105TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-8101
Practice Address - Country:US
Practice Address - Phone:682-270-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health