Provider Demographics
NPI:1114227972
Name:LITTLE, JILL K (MED LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:K
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MAN MAR DR STE 12
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2271
Mailing Address - Country:US
Mailing Address - Phone:508-341-9482
Mailing Address - Fax:774-306-3509
Practice Address - Street 1:30 MAN MAR DR STE 12
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2271
Practice Address - Country:US
Practice Address - Phone:508-341-9482
Practice Address - Fax:774-306-3509
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA7604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health