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General NPI Number Information
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NPI Number | 1003173303
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Entity Type | Organization
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Legal Business Name | PITT COUNSELING PLLC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 1912 E FIRE TOWER RD
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City | GREENVILLE
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State | NC
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Zip | 27858-4194
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Country | US
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Telephone | 252-355-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 E FIRE TOWER RD
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City | GREENVILLE
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State | NC
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Zip | 27858-4194
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICIAN/COUNSELOR
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Name | ANTHONY LAMONT HARRIS
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Credential |
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Telephone | 252-355-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | P006487
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License Number State | NC
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