1831815190 NPI number — CHOICES COUNSELING, INC.

Table of content: (NPI 1831815190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831815190 NPI number — CHOICES COUNSELING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHOICES COUNSELING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831815190
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 395
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62294-0395
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-505-0874
Provider Business Mailing Address Fax Number:
618-505-0785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 N MARKET ST UNIT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62959-2465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-505-0784
Provider Business Practice Location Address Fax Number:
618-505-0785
Provider Enumeration Date:
10/18/2022

Additional Information

Authorized Official

Authorized Official Last Name:
GALLON
Authorized Official First Name:
PEGGY
Authorized Official Middle Name:
Authorized Official Title or Position:
CRED & ENROLLMENT COORD
Authorized Official Telephone Number:
314-495-6037

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1104331289 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".




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