Provider Demographics
NPI:1447982954
Name:PITTMAN, LAURIE (LMHC, LMFT, LPC)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LMHC, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 ABBY RD
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6024
Mailing Address - Country:US
Mailing Address - Phone:813-447-9087
Mailing Address - Fax:
Practice Address - Street 1:503 ABBY RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6024
Practice Address - Country:US
Practice Address - Phone:813-447-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7644101YM0800X
FLMT3301106H00000X
FLMH12945101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist