Provider Demographics
NPI:1134349970
Name:LITTLE, JOE N
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:N
Last Name:LITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SOUTH 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:IL
Mailing Address - Zip Code:62341
Mailing Address - Country:US
Mailing Address - Phone:217-357-3176
Mailing Address - Fax:217-357-6609
Practice Address - Street 1:607 BUCHANAN STREET
Practice Address - Street 2:MENTAL HEALTH CENTERS OF WESTERN ILLINOIS
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321
Practice Address - Country:US
Practice Address - Phone:217-357-3176
Practice Address - Fax:217-357-6609
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health