Provider Demographics
NPI:1659536977
Name:CHOICES FOR LIFE COUNSELING INC.
Entity Type:Organization
Organization Name:CHOICES FOR LIFE COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LMFT LADC
Authorized Official - Phone:405-751-0800
Mailing Address - Street 1:4101 PERIMETER CENTER DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2302
Mailing Address - Country:US
Mailing Address - Phone:405-751-0800
Mailing Address - Fax:405-751-6488
Practice Address - Street 1:205 W HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-1547
Practice Address - Country:US
Practice Address - Phone:580-762-1200
Practice Address - Fax:580-762-2799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK8600134251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherMEDICARE