Phillips, Gena Pittman

Phillips, Gena Pittman is an sole proprietor health care provider with primary practice located at 1662 Booker Dairy Rd , Smithfield NC 27577-9405. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Phillips, Gena Pittman can be contacted via phone (919) 938-0046.

Contact Information

Primary practice address
1662 Booker Dairy Rd Smithfield NC 27577-9405
Phone: (919) 938-0046
Fax: (919) 938-0056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 887 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 5334 North Carolina

Profile Details

NPI number 1417019795
LBN Legal business name Phillips, Gena Pittman
Credentials LPC, LCAS, CCS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 14th, 2006
Last updated Sep 23rd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417019795 NPPES
North Carolina Other 5334 LPC
North Carolina MEDICAID 6103397 LPC
North Carolina Other 887 LPC

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