Provider Demographics
NPI:1255669545
Name:BOLDEN-LITTLE, DENISE ANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANNE
Last Name:BOLDEN-LITTLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2403
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2403
Mailing Address - Country:US
Mailing Address - Phone:256-531-8817
Mailing Address - Fax:
Practice Address - Street 1:512A MANN ST NE
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-5474
Practice Address - Country:US
Practice Address - Phone:256-531-8817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional