Provider Demographics
NPI:1356978969
Name:CHOICES 4 CHANGE COUNSELING AND COACHING LLC
Entity type:Organization
Organization Name:CHOICES 4 CHANGE COUNSELING AND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HOBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:623-252-1808
Mailing Address - Street 1:3707 E SOUTHERN AVE.
Mailing Address - Street 2:SUITE 2027
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:623-252-1808
Mailing Address - Fax:480-383-6968
Practice Address - Street 1:3707 E SOUTHERN AVE.
Practice Address - Street 2:SUITE 2027
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:623-252-1808
Practice Address - Fax:480-383-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty