Provider Demographics
NPI:1588935811
Name:LITTLE, COURTNEY BALLINGER (MA, LPC, CAADC)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:BALLINGER
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MA, LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2514
Mailing Address - Country:US
Mailing Address - Phone:989-779-9449
Mailing Address - Fax:989-779-2922
Practice Address - Street 1:218 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2514
Practice Address - Country:US
Practice Address - Phone:989-330-2800
Practice Address - Fax:989-779-2922
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008490101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor