Provider Demographics
NPI:1679756803
Name:ORTIZ, ARTHUR J (LIMHP)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13057 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3748
Mailing Address - Country:US
Mailing Address - Phone:402-499-6406
Mailing Address - Fax:402-330-7504
Practice Address - Street 1:13057 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3748
Practice Address - Country:US
Practice Address - Phone:402-499-6406
Practice Address - Fax:402-330-7504
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health