Provider Demographics
NPI:1790122885
Name:HORIZON COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:HORIZON COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BACKUS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-837-4995
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:WILLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06279-0537
Mailing Address - Country:US
Mailing Address - Phone:860-837-4995
Mailing Address - Fax:860-871-2239
Practice Address - Street 1:175 WEST RD
Practice Address - Street 2:SUITE 11
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3730
Practice Address - Country:US
Practice Address - Phone:860-837-4995
Practice Address - Fax:860-871-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003187251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health