Individual
MRS. GENA PITTMAN PHILLIPS
Active
Individual
MRS. GENA PITTMAN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCAS, CCS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
887
NC
101YP2500X
Professional Counselor
Primary
5334
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5334
LPC
NC
05
—
6103397
—
NC
01
—
887
LCAS
NC
Enumeration date
12/14/2006
Last updated
09/23/2010
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