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General NPI Number Information
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NPI Number | 1730943176
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Entity Type | Organization
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Legal Business Name | LISA LITTLE COUNSELING, LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 100 S 30TH ST STE C
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City | OZARK
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State | AR
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Zip | 72949-3746
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Country | US
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Telephone | 479-208-5383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | OZARK
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State | AR
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Zip | 72949-0386
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Country | US
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Telephone | 479-208-5383
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. LISA DIANN LITTLE
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Credential | LPC-S
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Telephone | 479-208-5383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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