Healthcare Provider Details

I. General information

NPI: 1730793530
Provider Name (Legal Business Name): CHOICE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7647 MONTE CARLO WAY
INDIANAPOLIS IN
46278-1936
US

IV. Provider business mailing address

7647 MONTE CARLO WAY
INDIANAPOLIS IN
46278-1936
US

V. Phone/Fax

Practice location:
  • Phone: 317-778-2826
  • Fax:
Mailing address:
  • Phone: 317-695-6183
  • Fax: 651-855-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALINA SMITH
Title or Position: CEO
Credential: PMHNP
Phone: 317-695-6182