Physician Compare National (NPI:1700047727)

HEALTHCARE PROVIDER: MARLENE ANNETTE LITTLETON LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1700047727
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901180660
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170123002764
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LITTLETON
	Individual professional last name
Provider First Name	MARLENE
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1170 W KANSAS ST
	Group Practice or individual's line 1 address
Line 2 Street Address	BLDG 10
	Group Practice or individual's line 2 address
City	LIBERTY
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	640682036
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y