Provider Demographics
NPI:1801828892
Name:DECISIONS PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:DECISIONS PSYCHOLOGICAL SERVICES PC
Other - Org Name:DECISIONS COUNSELING CENTER PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CHOATE
Authorized Official - Suffix:
Authorized Official - Credentials:HSPP
Authorized Official - Phone:574-223-8501
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-0777
Mailing Address - Country:US
Mailing Address - Phone:574-223-8501
Mailing Address - Fax:574-223-5744
Practice Address - Street 1:707 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46975-0777
Practice Address - Country:US
Practice Address - Phone:574-223-8501
Practice Address - Fax:574-223-5744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042082A103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200889770AMedicaid
IN000000480223OtherANTHEM
PTAN236390Medicare PIN