Individual provider Active NPI

Sara S Little, PH.D.

  • Clinical Psychologist
  • Bryan, TX
National Provider Identifier
1801852496
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38398 Issued in TX
Practice address
4045 Austins Estates Dr
Bryan, TX 77808-7301
Phone
(203) 397-6165
Fax
(662) 567-1007
NPI assigned
Apr 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS00574 RI
Clinical Psychologist 103TC0700X 38398 TX Primary

Addresses

Primary practice location

4045 Austins Estates Dr
Bryan, TX 77808-7301

Mailing address

4045 Austins Estates Dr
Bryan, TX 77808-7301
Phone (401) 578-1554

Other practice location 1

24 Salt Pond Rd
Suite B-4
Wakefield, RI 02879-4314
Phone (203) 397-6165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38398TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1801852496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 AUSTINS ESTATES DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778087301",
            "telephone_number": "401-578-1554",
            "fax_number": "662-567-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 AUSTINS ESTATES DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778087301",
            "telephone_number": "203-397-6165",
            "fax_number": "662-567-1007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Salt Pond Rd",
            "address_2": "Suite B-4",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794314",
            "country_code": "US",
            "telephone_number": "203-397-6165",
            "fax_number": "662-567-1007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "SARA",
        "middle_name": "S",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00574",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.