Basic Information
| Provider Information | |||||||||
| NPI: | 1316200793 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITTLES | ||||||||
| FirstName: | TERESKA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3218 CHARLES DR | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | CHALMETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042784006 | ||||||||
| FaxNumber: | 5042784007 | ||||||||
| Practice Location | |||||||||
| Address1: | 2626 CHARLES DR | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | CHALMETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042784006 | ||||||||
| FaxNumber: | 5042784007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2012 | ||||||||
| LastUpdateDate: | 05/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251G00000X | N | Agencies | Hospice Care, Community Based | 171M00000X | 11775 | LA | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.