Provider Demographics
NPI:1700047727
Name:LITTLETON, MARLENE ANNETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:ANNETTE
Last Name:LITTLETON
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 1:1911 LOUGHREY ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3097
Mailing Address - Country:US
Mailing Address - Phone:816-820-0306
Mailing Address - Fax:
Practice Address - Street 1:10 WESTOWNE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1166
Practice Address - Country:US
Practice Address - Phone:816-820-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0054821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical