Provider Demographics
NPI:1972907061
Name:LITTLE, KATIE M (LMHC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:M
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 1:817 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2042
Mailing Address - Country:US
Mailing Address - Phone:641-323-2729
Mailing Address - Fax:888-920-1276
Practice Address - Street 1:817 4TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2042
Practice Address - Country:US
Practice Address - Phone:641-323-2729
Practice Address - Fax:888-920-1276
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001564261QM0801X, 261QM0850X, 261QM0855X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health