Provider Demographics
NPI:1558757328
Name:LITTLE, JULIA (LSW)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-3810
Mailing Address - Country:US
Mailing Address - Phone:917-685-8384
Mailing Address - Fax:
Practice Address - Street 1:4475 ROUTE 27
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:08528-9601
Practice Address - Country:US
Practice Address - Phone:917-685-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05965200104100000X
NY72 074309104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker