Provider Demographics
NPI:1104254937
Name:LITTLETON, SOPHIE VERONICA (LCPC)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:VERONICA
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:SOPHIE
Other - Middle Name:L
Other - Last Name:BEHLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3624 216TH ST
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2713
Mailing Address - Country:US
Mailing Address - Phone:708-481-4086
Mailing Address - Fax:708-481-7725
Practice Address - Street 1:3624 216TH ST
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2713
Practice Address - Country:US
Practice Address - Phone:708-481-4086
Practice Address - Fax:708-481-7725
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010845101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional