Provider Demographics
NPI:1629586326
Name:LITTLE, BEVERLY MAE (LPC, PLPC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:MAE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LPC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5343
Mailing Address - Country:US
Mailing Address - Phone:785-393-6167
Mailing Address - Fax:888-965-5680
Practice Address - Street 1:1045 E 23RD ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-5343
Practice Address - Country:US
Practice Address - Phone:785-393-6167
Practice Address - Fax:888-965-5680
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health