Individual provider Active NPI

Jamilla Turner Little, LCSW

  • Clinical Social Worker
  • Wake Forest, NC
National Provider Identifier
1710902291
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005146 Issued in NC
Practice address
3104 Gross Ave
Wake Forest, NC 27587-6488
Phone
(919) 824-1980
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005146 NC Primary

Addresses

Primary practice location

3104 Gross Ave
Wake Forest, NC 27587-6488

Mailing address

3104 Gross Ave
Wake Forest, NC 27587-6488
Phone (919) 824-1980

Other identifiers 1

IdentifierTypeStateIssuer
6106200MedicaidNC

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1710902291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 GROSS AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876488",
            "telephone_number": "919-824-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 GROSS AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876488",
            "telephone_number": "919-824-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "JAMILLA",
        "middle_name": "TURNER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106200",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.