Organization
LITTLE-GERALD SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FASHENDA LITTLE GERALD (OPERATIONS MANAGER)
(704) 289-3831
Entity
Organization
Contact information
Practice address
1112 SKYWAY DR, MONROE, NC 28110
(704) 289-3831
Mailing address
1112 SKYWAY DR, MONROE, NC 28110-3045
(704) 289-3831
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30301
—
NC
05
—
32424
—
NC
05
—
32485
—
NC
Enumeration date
05/11/2016
Last updated
02/20/2021
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