Provider Demographics
NPI:1902889496
Name:LYTTLE, MARTHA S (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:S
Last Name:LYTTLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9829 47TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2717
Mailing Address - Country:US
Mailing Address - Phone:206-228-9341
Mailing Address - Fax:206-448-4899
Practice Address - Street 1:2003 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2162
Practice Address - Country:US
Practice Address - Phone:206-860-0155
Practice Address - Fax:206-448-4899
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005880101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health