Provider Demographics
NPI:1871749200
Name:LITTLE AND ASSOCIATES LLC
Entity type:Organization
Organization Name:LITTLE AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-510-3986
Mailing Address - Street 1:8830 CENTRE ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-2609
Mailing Address - Country:US
Mailing Address - Phone:662-510-3986
Mailing Address - Fax:662-510-3988
Practice Address - Street 1:8830 CENTRE ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2609
Practice Address - Country:US
Practice Address - Phone:662-510-3986
Practice Address - Fax:662-510-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS31-465103TC0700X
TNP0000001384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS680000164OtherMEDICARE PTEN
510G700396OtherMEDICARE - LA PTAN
512I680050OtherMEDICARE - LA MLH PTAN
MS00114932Medicaid