Provider Demographics
NPI:1689757957
Name:CHOICES COUNSELING AND CONSULTING, INC.
Entity Type:Organization
Organization Name:CHOICES COUNSELING AND CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BERUBE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS
Authorized Official - Phone:712-328-3700
Mailing Address - Street 1:300 W BROADWAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9045
Mailing Address - Country:US
Mailing Address - Phone:712-328-3700
Mailing Address - Fax:712-328-3721
Practice Address - Street 1:300 W BROADWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9045
Practice Address - Country:US
Practice Address - Phone:712-328-3700
Practice Address - Fax:712-328-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7430251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0487348Medicaid
NE10025194200Medicaid
IA1013490Medicaid