Provider Demographics
NPI:1972134724
Name:LITTLE, JACINTA LEVORA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JACINTA
Middle Name:LEVORA
Last Name:LITTLE
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 LAKE SIDE AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1723
Mailing Address - Country:US
Mailing Address - Phone:407-360-2848
Mailing Address - Fax:
Practice Address - Street 1:6150 METROWEST BLVD STE 305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3291
Practice Address - Country:US
Practice Address - Phone:855-204-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH19255101YM0800X
MH25180101YM0800X
FL25180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health