Provider Demographics
NPI:1013356856
Name:LITTLE, LATAVIA M (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:LATAVIA
Middle Name:M
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WARREN RD STE 25A
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5003
Mailing Address - Country:US
Mailing Address - Phone:443-939-5223
Mailing Address - Fax:
Practice Address - Street 1:17 WARREN RD STE 25A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5003
Practice Address - Country:US
Practice Address - Phone:443-939-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1133991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical