Provider Demographics
NPI:1194493403
Name:PITTMAN, COURTNEY LYNETTE (LCSWA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYNETTE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 ADAMS FARM PKWY APT J
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5087
Mailing Address - Country:US
Mailing Address - Phone:252-567-7223
Mailing Address - Fax:
Practice Address - Street 1:211 S CENTENNIAL ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-5215
Practice Address - Country:US
Practice Address - Phone:336-899-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0167341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical