Provider Demographics
NPI:1992965230
Name:LITTLE, ERIC C (PHD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:LITTLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 CAPITAL CIR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8401
Mailing Address - Country:US
Mailing Address - Phone:850-671-4600
Mailing Address - Fax:
Practice Address - Street 1:1965 CAPITAL CIR NE STE 100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8401
Practice Address - Country:US
Practice Address - Phone:850-671-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)