Provider Demographics
NPI:1982841854
Name:ORTEGA, RAYMOND CHARLES (LPC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CHARLES
Last Name:ORTEGA
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 1:2003 CLAPBOARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-5531
Mailing Address - Country:US
Mailing Address - Phone:501-227-0141
Mailing Address - Fax:
Practice Address - Street 1:707 S 1ST ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-6002
Practice Address - Country:US
Practice Address - Phone:501-985-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8103098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional