Provider Demographics
NPI:1932886348
Name:LITTLE, ELIZABETH (MA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 30TH AVE # 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6205
Mailing Address - Country:US
Mailing Address - Phone:206-356-0156
Mailing Address - Fax:
Practice Address - Street 1:155 30TH AVE # 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6205
Practice Address - Country:US
Practice Address - Phone:206-356-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health