Provider Demographics
NPI:1356315592
Name:LITTEN, KATHRYN K (EDS NCSP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:K
Last Name:LITTEN
Suffix:
Gender:F
Credentials:EDS NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 MEDICAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-434-3004
Mailing Address - Fax:540-433-2540
Practice Address - Street 1:1947 MEDICAL AVENUE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-434-3004
Practice Address - Fax:540-433-2540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000100103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA173071OtherSOUTHERN HEALTH
VA00242584OtherANTHEM