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General NPI Number Information
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NPI Number | 1558153809
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE OPTION SUPPORT SERVICES BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 3455 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30326-3254
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Country | US
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Telephone | 877-615-3288
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Fax |
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Provider Business Mailing Address
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Address Line | 3455 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30326-3254
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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 | CHIEF EXECUTIVE OFFICER
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Name | DR. KERRY PITTER
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Credential | PSYD
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Telephone | 973-651-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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