Provider Demographics
NPI:1043956105
Name:A LITTLE THERAPY, PLLC
Entity Type:Organization
Organization Name:A LITTLE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:850-601-1679
Mailing Address - Street 1:7901 4TH ST N STE 4000
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:850-601-1679
Mailing Address - Fax:
Practice Address - Street 1:8511 MYSLAK WAY UNIT 2210
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-7894
Practice Address - Country:US
Practice Address - Phone:850-601-1679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1881162220Medicaid