Provider Demographics
NPI:1407656358
Name:PITTS, GARRICK DEMETRUS JR
Entity type:Individual
Prefix:MR
First Name:GARRICK
Middle Name:DEMETRUS
Last Name:PITTS
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LOWERY ST APT 1110
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7067
Mailing Address - Country:US
Mailing Address - Phone:501-209-0580
Mailing Address - Fax:
Practice Address - Street 1:400 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-3024
Practice Address - Country:US
Practice Address - Phone:501-613-0385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician