MEDICARE: MRS. CAROLE ANN FOSTER-PITTS MSW, LCSW

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	101YM0800X	Mental Health Counselor	SW-38051	AZ
2	1041C0700X	Clinical Social Worker	SW38051	AZ
3	101YM0800X	Mental Health Counselor		AZ

General Provider Information

NPI Number	:	1437343431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLE ANN FOSTER-PITTS MSW, LCSW

Provider Business Mailing Address
First Line	:	8014 N. 16TH DRIVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021
Country	:	US
Telephone Number	:	602-620-0181
Fax Number	:	602-381-9907

Provider Business Practice Location Address
First Line	:	2400 AZ BILTMORE CIRCLE
Second Line	:	BLDG #4 SUITE 2430
City	:	PHOENIX
State	:	AZ
Zip	:	85016
Country	:	US
Telephone Number	:	602-620-0181
Fax Number	:	602-381-9907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2007
Last Update Date	:	12/05/2012

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