Jateasia Ashley Littles, MSW

Individual provider Active NPI Mental Health Counselor · Bristol, FL

NPI 1174138697 · NPPES record last updated Sep 11, 2020

Key facts

NPI
1174138697
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
10611 NW Sr 20
Bristol, FL 32321
Phone
(850) 643-1033
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
With Grace Counseling LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101Y00000X FL
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X FL Yes

Addresses

Primary practice location

10611 NW Sr 20
Bristol, FL 32321

Mailing address

3555 Sedona Loop
Tallahassee, FL 32308-6112
Phone (904) 434-9285

Other providers in Bristol, FL

All providers in Bristol, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.