Christian Raivon Pittman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.022909 Issued in IL

Practice address

2255 E 75TH St
Chicago, IL 60649-3228

Phone

(773) 721-7088

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aoba Enterprises, Inc

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1588398341
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1235883265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6516 S WOODLAWN AVE UNIT 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606374381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493228",
            "telephone_number": "773-721-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "CHRISTIAN",
        "middle_name": "RAIVON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "149.022909",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "c.phillips@acdservicesinc.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2255 E 75th St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606493228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chada Pitiranggon, MD
• Pitlosh Wound Specialists Inc
• Max John Pitlosh, M.D.
• Sean Pravin Pitroda, M.D.
• Kenneth S Pittleman, M.D.
• Donna M Pittman, PH.D.
• Jeanine Pittman
• Joyce Pittman, LPN
• Kenneth M. Pittner, D.D.S.
• Stephenie Pittroff, CPNP

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.