Provider Demographics
NPI:1083854772
Name:LITTMAN, MARK WILLIAM (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:WILLIAM
Last Name:LITTMAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 MOUNT BENEVOLENCE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-4321
Mailing Address - Country:US
Mailing Address - Phone:973-300-5338
Mailing Address - Fax:973-300-1931
Practice Address - Street 1:952 MOUNT BENEVOLENCE RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-4321
Practice Address - Country:US
Practice Address - Phone:973-300-5338
Practice Address - Fax:973-300-1931
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00366400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00366400OtherLICENSED PROFESSIONAL COUNSELOR