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General NPI Number Information
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NPI Number | 1649055633
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Entity Type | Individual
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Provider Name | GAGE LITTLEJOHN
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Gender | Male
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 65 MESSIMER DR
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City | NEWARK
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State | OH
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Zip | 43055-1874
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Country | US
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Telephone | 614-747-6547
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Fax |
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Provider Business Mailing Address
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Address Line | 65 MESSIMER DR
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City | NEWARK
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State | OH
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Zip | 43055-1874
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Country | US
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Telephone | 614-747-6547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2309456
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License Number State | OH
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