Individual provider Active NPI

William Little, PH.D.

  • Clinical Psychologist
  • Memphis, TN
National Provider Identifier
1780714832
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P-477 Issued in TN
Practice address
5349 Estate Office Drive-Suite 3
Memphis, TN 38119
Phone
(901) 767-6351
Fax
(901) 683-2876
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P-477 TN Primary

Addresses

Primary practice location

5349 Estate Office Drive-Suite 3
Memphis, TN 38119

Mailing address

5349 Estate Office Drive-Suite 3
Memphis, TN 38119
Phone (901) 767-6351

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109001109 TN Practitioner - Clinical Psychologist 5092738732 Practice locations: Memphis, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P-477TNMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780714832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 ESTATE OFFICE DRIVE-SUITE 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-767-6351",
            "fax_number": "901-683-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5349 ESTATE OFFICE DRIVE-SUITE 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-767-6351",
            "fax_number": "901-683-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P-477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.