Kimberly Harrell Littrell, APRN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

RN060422 Issued in GA

Practice address

2430 Tucker Dr
BLDG a
Loganville, GA 30052-4390

Phone

(770) 554-8812

Fax

(770) 554-9810

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Promedica, Inc.

  • Mental Health Counselor
  • Loganville, GA
  • NPI 1922036508
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1376600288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 TUCKER DR",
            "address_2": "BLDG A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524390",
            "telephone_number": "770-554-8812",
            "fax_number": "770-554-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 TUCKER DR",
            "address_2": "BLDG A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524390",
            "telephone_number": "770-554-8812",
            "fax_number": "770-554-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTRELL",
        "first_name": "KIMBERLY",
        "middle_name": "HARRELL",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "RN060422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS UPIN",
            "identifier": "088901",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lee Light, LDO
• Avadawn Lindsay, PHD, LPC, CPCS
• Maria Renee Lindsey, SLP
• Lisa L. Gentry Speech, Inc.
• Listening Hands Care Services, LLC
• Local Dental Partners, LLC
• Cheryl Lockett, PHD
• Loganville Community Ministry Village, Inc.
• Loganville Dental Associates
• Loganville Dentist Office, PC

• Mental Health Counselor in Loganville, GA
• Providers in Loganville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.