Provider Demographics
NPI:1275049017
Name:LITTLETON, STEPHEN JASPER (LAPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JASPER
Last Name:LITTLETON
Suffix:
Gender:M
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 GA HIGHWAY 96
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2584
Mailing Address - Country:US
Mailing Address - Phone:478-988-1222
Mailing Address - Fax:478-988-8098
Practice Address - Street 1:940 GA HIGHWAY 96 STE C
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2585
Practice Address - Country:US
Practice Address - Phone:478-988-1222
Practice Address - Fax:478-988-8098
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALAPC005058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health