Provider Demographics
NPI:1346455342
Name:EASTERN HORIZON COUNSELING SERVICES,INC.
Entity Type:Organization
Organization Name:EASTERN HORIZON COUNSELING SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:U
Authorized Official - Last Name:AJA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-445-4217
Mailing Address - Street 1:4616 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2222
Mailing Address - Country:US
Mailing Address - Phone:402-445-4217
Mailing Address - Fax:402-445-4188
Practice Address - Street 1:4616 N 36TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2222
Practice Address - Country:US
Practice Address - Phone:402-445-4217
Practice Address - Fax:402-445-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7396103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid