Provider Demographics
NPI:1578744108
Name:LITTLEJOHN, YVONNE LYDIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:LYDIA
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MORROW DR
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3303
Mailing Address - Country:US
Mailing Address - Phone:412-513-7896
Mailing Address - Fax:
Practice Address - Street 1:1000 JACKS RUN RD
Practice Address - Street 2:SUITE G
Practice Address - City:NORTH VERSAILLES
Practice Address - State:PA
Practice Address - Zip Code:15137-2744
Practice Address - Country:US
Practice Address - Phone:412-513-7896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125216104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10156097000001Medicaid