Provider Demographics
NPI:1689759391
Name:PITTSON, CAREY EDWARD (GUIDANCE COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:CAREY
Middle Name:EDWARD
Last Name:PITTSON
Suffix:
Gender:M
Credentials:GUIDANCE COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19108 E ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-6881
Mailing Address - Country:US
Mailing Address - Phone:480-759-1087
Mailing Address - Fax:
Practice Address - Street 1:20740 S ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-9058
Practice Address - Country:US
Practice Address - Phone:480-759-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool