Provider Demographics
NPI:1285753889
Name:BAKER-PITTS, CATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BAKER-PITTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W END AVE
Mailing Address - Street 2:#1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2749
Mailing Address - Country:US
Mailing Address - Phone:212-580-0015
Mailing Address - Fax:212-580-2784
Practice Address - Street 1:560 W END AVE
Practice Address - Street 2:#1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2749
Practice Address - Country:US
Practice Address - Phone:212-580-0015
Practice Address - Fax:212-580-2784
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR059191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNC4852Medicare ID - Type Unspecified