Provider Demographics
NPI:1881729739
Name:STITT, MARTHA C (ATR-BC, LPCC, CCDC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:C
Last Name:STITT
Suffix:
Gender:F
Credentials:ATR-BC, LPCC, CCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 ORMOND RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3420
Mailing Address - Country:US
Mailing Address - Phone:216-932-1321
Mailing Address - Fax:216-791-5610
Practice Address - Street 1:12200 FAIRHILL RD
Practice Address - Street 2:THE ART STUDIO - ROOM # C-155
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1058
Practice Address - Country:US
Practice Address - Phone:216-791-9303
Practice Address - Fax:216-791-5610
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH923211101YA0400X
OHE0001506101YP2500X
221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist