Provider Demographics
NPI:1366749426
Name:PITT, SHERYLYN HIATT (LCSW LCAS)
Entity type:Individual
Prefix:MS
First Name:SHERYLYN
Middle Name:HIATT
Last Name:PITT
Suffix:
Gender:F
Credentials:LCSW LCAS
Other - Prefix:MS
Other - First Name:SHERYL
Other - Middle Name:HIATT
Other - Last Name:PITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2664 TIMBER DR
Mailing Address - Street 2:SUITE 328
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2571
Mailing Address - Country:US
Mailing Address - Phone:919-749-3646
Mailing Address - Fax:
Practice Address - Street 1:2011 FORD GATES DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3765
Practice Address - Country:US
Practice Address - Phone:919-749-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1153101YA0400X
NCC0059931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)