Healthcare Provider Details

I. General information

NPI: 1164340295
Provider Name (Legal Business Name): KIMBERLY SUE PITTS LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N FANT ST
ANDERSON SC
29621-5702
US

IV. Provider business mailing address

110 MARTIN CT
WILLIAMSTON SC
29697-9525
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-3954
  • Fax:
Mailing address:
  • Phone: 864-419-1379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15510
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: