Provider Demographics
NPI:1336762855
Name:PITTMAN, ALYSON RACHELLE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:RACHELLE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:RACHELLE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10020 N RODNEY PARHAM RD STE G
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-5588
Mailing Address - Country:US
Mailing Address - Phone:501-680-2602
Mailing Address - Fax:
Practice Address - Street 1:10020 N RODNEY PARHAM RD STE G
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-5588
Practice Address - Country:US
Practice Address - Phone:501-680-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2005067101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health