Provider Demographics
NPI:1639246010
Name:MAKIN CHOICES INC
Entity Type:Organization
Organization Name:MAKIN CHOICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER MA LPC
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCS NCC CCSOTS
Authorized Official - Phone:910-257-4339
Mailing Address - Street 1:1076 STAMPER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4191
Mailing Address - Country:US
Mailing Address - Phone:910-483-2002
Mailing Address - Fax:910-483-4004
Practice Address - Street 1:1076 STAMPER RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4191
Practice Address - Country:US
Practice Address - Phone:910-483-2002
Practice Address - Fax:910-483-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301222OtherCIS
NC8301560Medicaid
NC3409108Medicaid
NC6791OtherNC BOARD OF PROF. COUNSEL