Provider Demographics
NPI:1881162220
Name:LITTLE, JENNIFER LEE (MAS, LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MAS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N STE 4000
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:850-601-1679
Mailing Address - Fax:
Practice Address - Street 1:3421 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-4669
Practice Address - Country:US
Practice Address - Phone:850-601-1679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3736106H00000X
ALL619106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist