Provider Demographics
NPI:1790450864
Name:LITTLE WREN COUNSELING LLC
Entity Type:Organization
Organization Name:LITTLE WREN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOGOWER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-580-1280
Mailing Address - Street 1:2193 ASSOCIATION DR STE 100
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-4904
Mailing Address - Country:US
Mailing Address - Phone:517-580-1280
Mailing Address - Fax:
Practice Address - Street 1:2193 ASSOCIATION DR STE 100
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-4904
Practice Address - Country:US
Practice Address - Phone:517-580-1280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty