Provider Demographics
NPI:1447022926
Name:PITTMAN, ELIZABETH (MA, LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 TEAL LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2739
Mailing Address - Country:US
Mailing Address - Phone:972-505-0564
Mailing Address - Fax:
Practice Address - Street 1:7165 COLLEYVILLE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8011
Practice Address - Country:US
Practice Address - Phone:817-697-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional