Provider Demographics
NPI:1053861104
Name:LITTLEJOHN, SHIRLENE ANITA (LCPC)
Entity type:Individual
Prefix:
First Name:SHIRLENE
Middle Name:ANITA
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N HOWARD ST APT 405
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-3435
Mailing Address - Country:US
Mailing Address - Phone:703-517-2594
Mailing Address - Fax:
Practice Address - Street 1:118 N HOWARD ST APT 405
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3435
Practice Address - Country:US
Practice Address - Phone:703-517-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health