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NPI Code Detail

MEDICARE: MS. JUDITH L. PITLICK M.A., L.P.C.C.

MEDICARE: MS. JUDITH L. PITLICK M.A., L.P.C.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorE-0000568OH
2102L00000XPsychoanalystE-0000568OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000361477OTHEROHBCBS NUMBER

General Provider Information

NPI Number : 1124247994
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUDITH L. PITLICK M.A., L.P.C.C.
Provider Business Mailing Address
First Line : 2593 CANTERBURY RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-4360
Country : US
Telephone Number : 216-932-2422
Fax Number :
Provider Business Practice Location Address
First Line : 19910 MALVERN RD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44122-2823
Country : US
Telephone Number : 216-991-4472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 09/11/2025

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