Provider Demographics
NPI:1861978595
Name:GIDDINS, LITA LITTLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LITA
Middle Name:LITTLE
Last Name:GIDDINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 E 880 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-3444
Mailing Address - Country:US
Mailing Address - Phone:801-310-3877
Mailing Address - Fax:
Practice Address - Street 1:947 E 880 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-3444
Practice Address - Country:US
Practice Address - Phone:801-310-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9463465-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health