Provider Demographics
NPI:1538519491
Name:LITTON-BAKER, MARSHA (LPC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:LITTON-BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PRINCETON RD
Mailing Address - Street 2:STE 403
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-2060
Mailing Address - Country:US
Mailing Address - Phone:423-302-3480
Mailing Address - Fax:423-722-3009
Practice Address - Street 1:508 PRINCETON RD
Practice Address - Street 2:STE 403
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2060
Practice Address - Country:US
Practice Address - Phone:423-302-3480
Practice Address - Fax:423-722-3009
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2700101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ024991Medicaid