Provider Demographics
NPI:1245902337
Name:PITTS, LINDA D
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:PITTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 SHIMMERING SKIES ST UNIT 1176
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4445
Mailing Address - Country:US
Mailing Address - Phone:323-807-3615
Mailing Address - Fax:
Practice Address - Street 1:3925 N MARTIN LUTHER KING BLVD
Practice Address - Street 2:#206
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031
Practice Address - Country:US
Practice Address - Phone:323-807-3615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health