Provider Demographics
NPI:1639442668
Name:ADURAY COUNSELING SERVICES
Entity Type:Organization
Organization Name:ADURAY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-304-4622
Mailing Address - Street 1:1036 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3530
Mailing Address - Country:US
Mailing Address - Phone:402-304-4622
Mailing Address - Fax:402-328-0346
Practice Address - Street 1:1036 LAKE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3530
Practice Address - Country:US
Practice Address - Phone:402-304-4622
Practice Address - Fax:402-328-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE484251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025502500OtherMAGELLAN HEALTH SERVICES
NE600005706Medicaid