Healthcare Provider Details

I. General information

NPI: 1558280883
Provider Name (Legal Business Name): DANIEL AUSTIN LITTLE I LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 E I 20 STE 108
ALEDO TX
76008-3105
US

IV. Provider business mailing address

6900 E I 20 STE 108
ALEDO TX
76008-3105
US

V. Phone/Fax

Practice location:
  • Phone: 817-458-8648
  • Fax:
Mailing address:
  • Phone: 817-458-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number95644
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: