Healthcare Provider Details

I. General information

NPI: 1104400951
Provider Name (Legal Business Name): LORRAINE LITTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 E PALM CANYON DR UNIT 34
PALM SPRINGS CA
92264-9173
US

IV. Provider business mailing address

1150 E PALM CANYON DR UNIT 34
PALM SPRINGS CA
92264-9173
US

V. Phone/Fax

Practice location:
  • Phone: 760-567-6221
  • Fax:
Mailing address:
  • Phone: 760-567-6221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101071
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number101071
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number101071
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: