Active NPI
Tiffany J Pittman, MA, LPC, AADC
- Professional Counselor
- Barboursville, WV
National Provider Identifier
1629489356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1841
- Practice address
- 2 Chateau Grove LN
Barboursville, WV 25504 - Phone
- (304) 736-9662
- Fax
- (304) 733-0079
- NPI assigned
- May 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 06-304 | WV | |
| Professional Counselor | 101YP2500X | 1841 | WV | Primary |
Addresses
Primary practice location
2 Chateau Grove LN
Barboursville, WV 25504
Mailing address
97 Great Teays Blvd Ste 6
Scott Depot, WV 25560-9816
Phone (304) 757-6999
Other practice location 1
97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560-9815
Phone (304) 757-6999
Other practice location 2
97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560-9815
Phone (304) 757-6999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629489356 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06-304 | WV | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1629489356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 GREAT TEAYS BLVD STE 6",
"city": "SCOTT DEPOT",
"state": "WV",
"postal_code": "255609816",
"telephone_number": "304-757-6999",
"fax_number": "304-201-5019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CHATEAU GROVE LN",
"city": "BARBOURSVILLE",
"state": "WV",
"postal_code": "25504",
"telephone_number": "304-736-9662",
"fax_number": "304-733-0079"
}
],
"practiceLocations": [
{
"address_1": "97 Great Teays Blvd",
"address_2": "Ste 6",
"address_purpose": "LOCATION",
"city": "Scott Depot",
"state": "WV",
"postal_code": "255609815",
"country_code": "US",
"telephone_number": "304-757-6999",
"fax_number": "304-757-3252",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "97 Great Teays Blvd",
"address_2": "Ste 6",
"address_purpose": "LOCATION",
"city": "Scott Depot",
"state": "WV",
"postal_code": "255609815",
"country_code": "US",
"telephone_number": "304-757-6999",
"fax_number": "304-757-3252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PITTMAN",
"first_name": "TIFFANY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "MA, LPC, AADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-15",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WV",
"license": "06-304",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WV",
"license": "1841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629489356",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barboursville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.