Provider Demographics
NPI:1881129971
Name:PITCOCK, KATY (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:PITCOCK
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 SGT ED HOLCOMB BLVD S
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1990
Mailing Address - Country:US
Mailing Address - Phone:936-521-6100
Mailing Address - Fax:
Practice Address - Street 1:1523 NORMAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4297
Practice Address - Country:US
Practice Address - Phone:855-862-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional