Provider Demographics
NPI:1952543845
Name:PITTSLEY, ALICE L (LCSW, LADC)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:L
Last Name:PITTSLEY
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 TATE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1761
Mailing Address - Country:US
Mailing Address - Phone:775-787-5729
Mailing Address - Fax:775-787-6984
Practice Address - Street 1:85 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3432
Practice Address - Country:US
Practice Address - Phone:777-324-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV152101YA0400X
NV3080-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)