Provider Demographics
NPI:1083330443
Name:CHOICES COUNSELING, INC.
Entity Type:Organization
Organization Name:CHOICES COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-505-0784
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-0395
Mailing Address - Country:US
Mailing Address - Phone:618-505-0784
Mailing Address - Fax:618-505-0785
Practice Address - Street 1:1315 MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-3720
Practice Address - Country:US
Practice Address - Phone:618-505-2784
Practice Address - Fax:618-505-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)