Provider Demographics
NPI:1720722390
Name:ADDERLEY, ODDETTE PITTER (LMHC)
Entity Type:Individual
Prefix:
First Name:ODDETTE
Middle Name:PITTER
Last Name:ADDERLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6646
Mailing Address - Country:US
Mailing Address - Phone:305-495-8219
Mailing Address - Fax:
Practice Address - Street 1:10031 PINES BLVD STE 248
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6180
Practice Address - Country:US
Practice Address - Phone:305-570-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20544101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional