| Kathleen Little Psychotherapy Llc | |
|
51 Upper Montclair Plz Suite 21 Upper Montclair NJ 07043-1343 | |
| (201) 306-4015 | |
| Not Available |
| Full Name | Kathleen Little Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 51 Upper Montclair Plz, Upper Montclair, New Jersey |
| Authorized Official Name and Position | Kathleen Little (THERAPIST) |
| Authorized Official Contact | 2013064015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Little Psychotherapy Llc 33 Highfield Ln Cedar Grove NJ 07009-1503 Ph: (201) 306-4015 | Kathleen Little Psychotherapy Llc 51 Upper Montclair Plz Suite 21 Upper Montclair NJ 07043-1343 Ph: (201) 306-4015 |
| NPI Number | 1205178290 |
|---|---|
| Provider Enumeration Date | 03/18/2013 |
| Last Update Date | 03/18/2013 |
| Medicare PECOS PAC ID | 0547405508 |
|---|---|
| Medicare Enrollment ID | O20130321000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205178290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC01478100 (New Jersey) | Primary |
| Provider Name | Kathleen M Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629100771 PECOS PAC ID: 7012152085 Enrollment ID: I20130321000537 |
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