Healthcare Provider Details

I. General information

NPI: 1427047125
Provider Name (Legal Business Name): CAROL B PITTS PH.D., LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 CLAIRMONT RD
DECATUR GA
30033-3405
US

IV. Provider business mailing address

1814 CLAIRMONT RD
DECATUR GA
30033-3405
US

V. Phone/Fax

Practice location:
  • Phone: 404-636-1457
  • Fax: 404-636-7449
Mailing address:
  • Phone: 404-636-1457
  • Fax: 404-636-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC001788
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT000795
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: