Provider Demographics
NPI:1548980063
Name:LITTLEJOHN, KELLI ARNESE (LMHP-R)
Entity type:Individual
Prefix:MISS
First Name:KELLI
Middle Name:ARNESE
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:LMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6406
Mailing Address - Country:US
Mailing Address - Phone:804-250-6028
Mailing Address - Fax:
Practice Address - Street 1:10015 W BROAD ST
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6406
Practice Address - Country:US
Practice Address - Phone:804-250-6028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health