Individual provider Active NPI

Marolyn Ann Little, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Anderson, SC
National Provider Identifier
1699791236
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1180 Issued in SC
Practice address
102 Buford Ave Ste a
Anderson, SC 29621-3365
Phone
(864) 261-9506
Fax
(864) 226-4201
NPI assigned
Jul 15, 2006
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1180 SC Primary

Addresses

Primary practice location

102 Buford Ave Ste a
Anderson, SC 29621-3365

Mailing address

102 Buford Ave Ste a
Anderson, SC 29621-3365
Phone (864) 261-9506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061106000560 SC Practitioner - Nurse Practitioner 7012914930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Wellness Center LLCGroup PAC ID 8527406545, 10 clinicians

Practice addresses (Care Compare)

102 Buford Ave
Suite a
Anderson, SC 29621-3365
Phone (864) 261-9506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Wellness Center LLC CurrentSince Aug 1, 2025 Accepting new patients
Sherbondy's LLC Psychiatric Services PastSince Apr 2, 2015 Accepting new patients

Locations

102 Buford Ave
Ste A
Anderson, SC 29621
Phone (864) 224-2325

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1699791236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE STE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213365",
            "telephone_number": "864-261-9506",
            "fax_number": "864-226-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE STE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213365",
            "telephone_number": "864-261-9506",
            "fax_number": "864-226-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "MAROLYN",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "1180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.