Provider Demographics
NPI:1578566915
Name:CHOICES COUNSELING SERVICES, P.C.
Entity Type:Organization
Organization Name:CHOICES COUNSELING SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-548-8727
Mailing Address - Street 1:607 LINCOLNWAY
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5727
Mailing Address - Country:US
Mailing Address - Phone:219-548-8727
Mailing Address - Fax:219-465-7211
Practice Address - Street 1:607 LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5727
Practice Address - Country:US
Practice Address - Phone:219-548-8727
Practice Address - Fax:219-465-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2011-11-16
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
IN200275200Medicaid