Provider Demographics
NPI:1912678830
Name:LITTLE LIGHT PSYCHOTHERAPY, PLLC
Entity Type:Organization
Organization Name:LITTLE LIGHT PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW-CP, LCAS
Authorized Official - Phone:828-226-6484
Mailing Address - Street 1:PO BOX 1042
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-1042
Mailing Address - Country:US
Mailing Address - Phone:828-226-6484
Mailing Address - Fax:
Practice Address - Street 1:4 LYNN COVE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1909
Practice Address - Country:US
Practice Address - Phone:828-226-6484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty