MEDICARE: PITT COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	P006487	NC

General Provider Information

NPI Number	:	1003173303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PITT COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1912 E FIRE TOWER RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-4194
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 E FIRE TOWER RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-4194
Country	:	US
Telephone Number	:	252-355-3060
Fax Number	:

Authorized Official
Title or Position	:	CLINICIAN/COUNSELOR
Name	:	ANTHONY LAMONT HARRIS
Credential	:
Telephone Number	:	252-355-3060

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	04/12/2012

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