Kizzy Dianna Pittrell, EDD, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1120 Middle River Road
Middle River, MD 21220

Phone

(443) 868-7762

Fax

(443) 868-7643

NPI assigned

Aug 10, 2011

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

Other names 1

• Ms. Kizzy Dianna Ross Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Ross Counseling LLC

  • Mental Health Counselor
  • Middle River, MD
  • NPI 1679185607
  NPD Authorized official
• Strengthening Families Building Communities

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Middle River, MD
  • NPI 1801612528
  NPD Authorized official
• Strengthening Families Building Communities

  • Community/Behavioral Health Agency
  • Rosedale, MD
  • NPI 1871139741
  NPD Authorized official

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1528347366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MIDDLE RIVER ROAD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "21220",
            "telephone_number": "301-609-9887",
            "fax_number": "301-609-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MIDDLE RIVER ROAD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "21220",
            "telephone_number": "443-868-7762",
            "fax_number": "443-868-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTRELL",
        "first_name": "KIZZY",
        "middle_name": "DIANNA",
        "name_prefix": "Dr.",
        "credential": "EDD, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589561800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIZZY",
            "last_name": "ROSS",
            "middle_name": "DIANNA",
            "prefix": "MS.",
            "credential": "EDD, LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Paul, CPRP
• Erica L Payne, PHD
• Peace of Mind Support Services Inc.
• People Encouraging People, Inc.
• Michael J Petti
• Plus Essentials Healthcare Services Corp
• Kimberly Rose Podhorniak
• Nicholas Konstantinos Polikandriotis, PHARMD
• Premise Health of Maryland Medical P C
• Latrice Price

• All providers in Middle River, MD
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.