Provider Demographics
NPI:1285199646
Name:FIRST CHOICE COUNSELING PC
Entity Type:Organization
Organization Name:FIRST CHOICE COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CLINICAL SERVICES
Authorized Official - Prefix:PROF
Authorized Official - First Name:NAAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUDERDALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, PHD CESABD
Authorized Official - Phone:314-762-6363
Mailing Address - Street 1:569 MELVILLE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4512
Mailing Address - Country:US
Mailing Address - Phone:314-762-6363
Mailing Address - Fax:
Practice Address - Street 1:569 MELVILLE AVE STE 202
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-4512
Practice Address - Country:US
Practice Address - Phone:314-762-6363
Practice Address - Fax:877-819-8247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-09
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty