Provider Demographics
NPI:1598890840
Name:LITTLE, HEATHER (LSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1007
Mailing Address - Country:US
Mailing Address - Phone:412-995-5000
Mailing Address - Fax:412-995-5044
Practice Address - Street 1:711 BINGHAM ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1007
Practice Address - Country:US
Practice Address - Phone:412-995-5000
Practice Address - Fax:412-995-5044
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW04406E171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019109220002Medicaid