Provider Demographics
NPI:1811947591
Name:CONCIOUS CHOICES COUNSELING
Entity type:Organization
Organization Name:CONCIOUS CHOICES COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:G
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MSS, LCSW
Authorized Official - Phone:302-528-5517
Mailing Address - Street 1:7 QUARRY LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-4810
Mailing Address - Country:US
Mailing Address - Phone:302-528-5517
Mailing Address - Fax:302-832-7313
Practice Address - Street 1:7 QUARRY LN
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4810
Practice Address - Country:US
Practice Address - Phone:302-528-5517
Practice Address - Fax:302-832-7313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-0000523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE491419Medicare ID - Type UnspecifiedMENTAL HEALTH PROVIDER