Provider Demographics
NPI:1891991444
Name:LITTERER, JILL A (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:A
Last Name:LITTERER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:ANNETTE
Other - Last Name:LITTERER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:3475 JERSEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2293
Mailing Address - Country:US
Mailing Address - Phone:563-468-0659
Mailing Address - Fax:563-355-1660
Practice Address - Street 1:3475 JERSEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2293
Practice Address - Country:US
Practice Address - Phone:563-468-0659
Practice Address - Fax:563-355-1660
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IA000162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist