Provider Demographics
NPI:1588717060
Name:LITTEN, DELILLIAN VIOLA (LPC)
Entity type:Individual
Prefix:
First Name:DELILLIAN
Middle Name:VIOLA
Last Name:LITTEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 RADCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5318
Mailing Address - Country:US
Mailing Address - Phone:919-787-6049
Mailing Address - Fax:
Practice Address - Street 1:3622 HAWORTH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7219
Practice Address - Country:US
Practice Address - Phone:919-847-3035
Practice Address - Fax:919-845-5123
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102817Medicaid