Individual provider Active NPI

Justin Gerald Bixby Little, M.S., LMFT

  • Marriage & Family Therapist
  • Sisters, OR
National Provider Identifier
1720456635
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1903 Issued in OR
Practice address
704 W Hood Ave Ste D
Sisters, OR 97759-1529
Phone
(541) 640-9310
NPI assigned
Sep 9, 2015
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF60817829 WA
Marriage & Family Therapist 106H00000X T1903 OR Primary

Addresses

Primary practice location

704 W Hood Ave Ste D
Sisters, OR 97759-1529

Mailing address

615 N Meadow LN
Sisters, OR 97759-3148
Phone (360) 553-2814

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
T1903ORMDMarriage & Family Therapist
LF60817829WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Integrative Nutrition and Therapy CurrentSince Jul 21, 2024 Accepting new patients
Children's Home Society of Washington Past Accepting new patients

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1720456635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N MEADOW LN",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977593148",
            "telephone_number": "360-553-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W HOOD AVE STE D",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977591529",
            "telephone_number": "541-640-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "JUSTIN",
        "middle_name": "GERALD BIXBY",
        "name_prefix": "Mr.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60817829",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisters, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.