Provider Demographics
NPI:1700982386
Name:LITTLE, NANCY A (PCC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:LITTLE
Suffix:
Gender:M
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 HESS ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2679
Mailing Address - Country:US
Mailing Address - Phone:614-999-4122
Mailing Address - Fax:888-216-8339
Practice Address - Street 1:1508 HESS ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:OH
Practice Address - Zip Code:43212-2679
Practice Address - Country:US
Practice Address - Phone:614-999-4122
Practice Address - Fax:888-216-8339
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE7723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional