Provider Demographics
NPI:1023334810
Name:CHOICES IN COUNSELING LLC
Entity type:Organization
Organization Name:CHOICES IN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANGEBRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-346-6252
Mailing Address - Street 1:901 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-1269
Mailing Address - Country:US
Mailing Address - Phone:317-346-6252
Mailing Address - Fax:317-245-2367
Practice Address - Street 1:901 N MAIN ST
Practice Address - Street 2:#B
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1269
Practice Address - Country:US
Practice Address - Phone:317-346-6252
Practice Address - Fax:317-245-2367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005036A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201010610 AOtherMEDICAID PRTF WAIVER
IN200952220AMedicaid