MEDICARE: MRS. JACINTA LEVORA LITTLE LMHC

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
1	101YM0800X	Mental Health Counselor	IMH19255	FL
2	101YM0800X	Mental Health Counselor	MH25180
3	101YM0800X	Mental Health Counselor	25180	FL

General Provider Information

NPI Number	:	1972134724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACINTA LEVORA LITTLE LMHC

Provider Business Mailing Address
First Line	:	1755 LAKE SIDE AVE
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-1723
Country	:	US
Telephone Number	:	407-360-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 METROWEST BLVD STE 305
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3291
Country	:	US
Telephone Number	:	855-204-2767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	02/27/2025

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