Provider Demographics
NPI:1710347547
Name:MAKIN' CHOICES, INC.
Entity Type:Organization
Organization Name:MAKIN' CHOICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
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:LPC
Authorized Official - Phone:910-257-4339
Mailing Address - Street 1:2000 CHAPEL HILL RD
Mailing Address - Street 2:SUITE #23
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1197
Mailing Address - Country:US
Mailing Address - Phone:919-490-8041
Mailing Address - Fax:919-493-5957
Practice Address - Street 1:8300 AMBER LANTERN ST
Practice Address - Street 2:#203
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4575
Practice Address - Country:US
Practice Address - Phone:919-519-3560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6791251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409018Medicaid