Provider Demographics
NPI:1720828155
Name:LITTLE, ASYA M (MA, LCMHCA)
Entity type:Individual
Prefix:
First Name:ASYA
Middle Name:M
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 EUGENE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2714
Mailing Address - Country:US
Mailing Address - Phone:336-365-8354
Mailing Address - Fax:336-365-2380
Practice Address - Street 1:418 EUGENE CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2714
Practice Address - Country:US
Practice Address - Phone:336-365-8354
Practice Address - Fax:336-365-2380
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20085101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional