Provider Demographics
NPI:1780116855
Name:LITTLETON COUNSELING, LLC
Entity type:Organization
Organization Name:LITTLETON COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:ISADORE
Authorized Official - Last Name:MALKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-441-4564
Mailing Address - Street 1:7325 S PIERCE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4553
Mailing Address - Country:US
Mailing Address - Phone:720-441-4564
Mailing Address - Fax:
Practice Address - Street 1:7325 S PIERCE ST
Practice Address - Street 2:STE 101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4553
Practice Address - Country:US
Practice Address - Phone:720-441-4564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty