Individual
CHARLES ERNEST EASTERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
111 VESTA RD, SALIDA, CO 81201-9327
(719) 285-5939
Mailing address
111 VESTA RD, SALIDA, CO 81201-9327
(719) 285-5939
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ACD.0002349
CO
106H00000X
Marriage & Family Therapist
Primary
MFT.0002861
CO
Other
Enumeration date
12/04/2023
Last updated
04/15/2025
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