Provider Demographics
NPI:1740815745
Name:PITTMAN, ASHLEY (MA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 OCONNELL DR APT 202
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-1149
Mailing Address - Country:US
Mailing Address - Phone:630-538-3728
Mailing Address - Fax:
Practice Address - Street 1:7001 OCONNELL DR APT 202
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-1149
Practice Address - Country:US
Practice Address - Phone:630-538-3728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor