Provider Demographics
NPI:1073680450
Name:CHOICES PSY SERVICES
Entity Type:Organization
Organization Name:CHOICES PSY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-223-8590
Mailing Address - Street 1:710 WEST 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701
Mailing Address - Country:US
Mailing Address - Phone:620-223-8590
Mailing Address - Fax:620-223-8592
Practice Address - Street 1:710 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701
Practice Address - Country:US
Practice Address - Phone:620-223-8590
Practice Address - Fax:620-223-8592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS119063Medicare ID - Type Unspecified