Doctor Name: | NICHOLAS PITARYS |
NPI Number: | 1326464322 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | LM12288 |
Business Practice Address: | 39 Western Ave Suite B South Paris, ME - 042811412 |
Business Phone Number: | 2077431677 |
Business Fax Number: | |
Mailing Address: | 39 Pismire Mountain Rd, RAYMOND |
State: | ME |
Postal Code: | 040716176 |
Phone Number: | 2073101001 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2014 |
NPI Last Update Date: | 03/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LM12288 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |