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NPI Code Detail

MEDICARE: CHARLES ERWIN LITTLE III CSW

MEDICARE: CHARLES ERWIN LITTLE III CSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorNM

General Provider Information

NPI Number : 1770459042
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES ERWIN LITTLE III CSW
Provider Business Mailing Address
First Line : 4730 BECKNER RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-3691
Country : US
Telephone Number : 505-231-9306
Fax Number :
Provider Business Practice Location Address
First Line : 4730 BECKNER RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-3691
Country : US
Telephone Number : 505-231-9306
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2025
Last Update Date : 05/19/2026

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Directions to “ CHARLES ERWIN LITTLE III CSW” Practice Location

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