Provider Demographics
NPI:1376522433
Name:LIMOGES, CLINTON RYAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:RYAN
Last Name:LIMOGES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11321 I-30
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7040
Mailing Address - Country:US
Mailing Address - Phone:501-202-7587
Mailing Address - Fax:
Practice Address - Street 1:11321 I-30
Practice Address - Street 2:SUITE 104
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7040
Practice Address - Country:US
Practice Address - Phone:501-202-7587
Practice Address - Fax:501-202-6683
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0705019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health