Healthcare Provider Details

I. General information

NPI: 1366361230
Provider Name (Legal Business Name): SHYLYNN KIANA LITTLE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W 11TH ST
PUEBLO CO
81003-2801
US

IV. Provider business mailing address

501 7TH ST
FOWLER CO
81039-1116
US

V. Phone/Fax

Practice location:
  • Phone: 719-506-0216
  • Fax:
Mailing address:
  • Phone: 719-924-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022294
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: