Basic Information
Provider Information
NPI: 1467516484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIMBAUGH
FirstName: RITA
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: M.ED.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CONVILLE
OtherFirstName: RITA
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4040 MEMORIAL PKWY SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358024364
CountryCode: US
TelephoneNumber: 2565331970
FaxNumber: 2565324112
Practice Location
Address1: 4040 MEMORIAL PKWY SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358024364
CountryCode: US
TelephoneNumber: 2565331970
FaxNumber: 2565324112
Other Information
ProviderEnumerationDate: 12/21/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  X Behavioral Health & Social Service ProvidersCounselor 
101YM0800X  X Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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