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General NPI Number Information
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NPI Number | 1265831200
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR CHILD AND FAMILY THERAPY
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 11215 HERMITAGE RD STE 200
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3864
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Country | US
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Telephone | 501-844-0394
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Fax |
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Provider Business Mailing Address
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Address Line | 3723 GRACEFUL OAKS DR
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City | BENTON
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State | AR
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Zip | 72019-2028
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Country | US
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Telephone | 501-844-0391
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. CHERYE RENEE LIMOGES
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Credential | LPC
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Telephone | 501-844-0394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P0704017
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License Number State | AR
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