Provider Demographics
NPI:1154765659
Name:PITTMAN, ARNITA DENIECE (LICDC)
Entity type:Individual
Prefix:MRS
First Name:ARNITA
Middle Name:DENIECE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 MARION WALDO RD
Mailing Address - Street 2:UNIT 240
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-7421
Mailing Address - Country:US
Mailing Address - Phone:740-262-2370
Mailing Address - Fax:740-386-2005
Practice Address - Street 1:1461 MARION WALDO RD
Practice Address - Street 2:UNIT 240
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-7421
Practice Address - Country:US
Practice Address - Phone:740-262-2370
Practice Address - Fax:740-386-2005
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH601193101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)