Provider Demographics
NPI:1437019965
Name:LIMMITT, ROBERT BERNARD
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BERNARD
Last Name:LIMMITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 CENTRAL ST APT 9
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48209-1142
Mailing Address - Country:US
Mailing Address - Phone:313-661-7130
Mailing Address - Fax:
Practice Address - Street 1:2683 CENTRAL ST APT 9
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-1142
Practice Address - Country:US
Practice Address - Phone:313-661-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL530745085574106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty