Provider Demographics
NPI:1386279669
Name:LITTLE, ALEXA DANIELLE (LMFTA)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:DANIELLE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2468 FAY JONES RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-6726
Mailing Address - Country:US
Mailing Address - Phone:704-742-6126
Mailing Address - Fax:
Practice Address - Street 1:6412 BANNINGTON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1327
Practice Address - Country:US
Practice Address - Phone:704-742-6126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12205A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist