Individual
CHRISTIAN RAIVON PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2255 E 75TH ST, CHICAGO, IL 60649-3228
(773) 721-7088
Mailing address
6516 S WOODLAWN AVE UNIT 1N, CHICAGO, IL 60637-4381
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.022909
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.022909
LICENSE
IL
Enumeration date
02/08/2022
Last updated
02/08/2022
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