Provider Demographics
NPI:1679971147
Name:LITTLE, MEREDITH (LPC)
Entity type:Individual
Prefix:MISS
First Name:MEREDITH
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 RUTLEDGE AVE
Mailing Address - Street 2:APT. B
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1333
Mailing Address - Country:US
Mailing Address - Phone:843-290-1017
Mailing Address - Fax:843-884-2184
Practice Address - Street 1:680 SAINT ANDREWS BLVD STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7346
Practice Address - Country:US
Practice Address - Phone:843-259-2459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health