Provider Demographics
NPI:1205178290
Name:KATHLEEN LITTLE PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:KATHLEEN LITTLE PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-306-4015
Mailing Address - Street 1:33 HIGHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1503
Mailing Address - Country:US
Mailing Address - Phone:201-306-4015
Mailing Address - Fax:
Practice Address - Street 1:51 UPPER MONTCLAIR PLZ
Practice Address - Street 2:SUITE 21
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1343
Practice Address - Country:US
Practice Address - Phone:201-306-4015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014781001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty