Healthcare Provider Details

I. General information

NPI: 1851422786
Provider Name (Legal Business Name): PAULETTE D PITT PH.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAULETTE D CIVICK PHD

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST SUITE 4011
SHERMAN TX
75090-2881
US

IV. Provider business mailing address

600 E TAYLOR ST SUITE 4011
SHERMAN TX
75090-2881
US

V. Phone/Fax

Practice location:
  • Phone: 903-893-0298
  • Fax: 903-892-6323
Mailing address:
  • Phone: 903-893-0298
  • Fax: 903-892-6323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19902
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number34263
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: