MEDICARE: MRS. KRISTIN LYNN HOLLAND-PITTS MS, LPC-S

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
1	101YP2500X	Professional Counselor	6489	OK
2	101YM0800X	Mental Health Counselor	6489	OK

General Provider Information

NPI Number	:	1639443914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN LYNN HOLLAND-PITTS MS, LPC-S

Provider Business Mailing Address
First Line	:	801 QUAIL RIDGE RD
Second Line	:
City	:	NEWCASTLE
State	:	OK
Zip	:	73065-5822
Country	:	US
Telephone Number	:	405-669-1989
Fax Number	:

Provider Business Practice Location Address
First Line	:	8524 S WESTERN AVE STE 107
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9247
Country	:	US
Telephone Number	:	405-669-1989
Fax Number	:	405-294-1166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2012
Last Update Date	:	08/30/2024

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