Provider Demographics
NPI:1457414542
Name:PITTMAN, ANGELA (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 UPSHUR STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1644
Mailing Address - Country:US
Mailing Address - Phone:301-699-8760
Mailing Address - Fax:
Practice Address - Street 1:1120 G STREET NW
Practice Address - Street 2:#550
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3896
Practice Address - Country:US
Practice Address - Phone:301-699-8760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC300238104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker