Provider Demographics
NPI:1811358096
Name:LITTRELL, KYRA A (LMHC, LCAC)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:A
Last Name:LITTRELL
Suffix:
Gender:F
Credentials:LMHC, LCAC
Other - Prefix:
Other - First Name:KYRA
Other - Middle Name:A
Other - Last Name:RANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:SCIPIO
Mailing Address - State:IN
Mailing Address - Zip Code:47273-0094
Mailing Address - Country:US
Mailing Address - Phone:812-592-8698
Mailing Address - Fax:
Practice Address - Street 1:517 AMVETS DR
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-1616
Practice Address - Country:US
Practice Address - Phone:812-718-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001648A101YA0400X
IN39003485A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)