Provider Demographics
NPI:1922792407
Name:LITLE, SHANNON (AMFT)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:
Last Name:LITLE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:KOWALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1243
Mailing Address - Country:US
Mailing Address - Phone:707-242-1303
Mailing Address - Fax:
Practice Address - Street 1:1900 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1243
Practice Address - Country:US
Practice Address - Phone:707-242-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT139490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health