Provider Demographics
NPI:1013453596
Name:LITTLEJOHN, JOHNEA (LCSWA)
Entity type:Individual
Prefix:
First Name:JOHNEA
Middle Name:
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WHITTENBURG DR
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-5071
Mailing Address - Country:US
Mailing Address - Phone:864-425-1473
Mailing Address - Fax:
Practice Address - Street 1:107 WHITTENBURG DR
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-5071
Practice Address - Country:US
Practice Address - Phone:864-425-1473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP011181101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health