Provider Demographics
NPI:1922303973
Name:LITTLE, KIMBERLY LYNNE (MA, MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNNE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MA, MSW, LCSW
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:LYNNE
Other - Last Name:SEEGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3044 W. BEARSS AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618
Mailing Address - Country:US
Mailing Address - Phone:813-964-5511
Mailing Address - Fax:813-341-5511
Practice Address - Street 1:3044 W. BEARSS AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-964-5511
Practice Address - Fax:813-341-5511
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW51311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical