Healthcare Provider Details

I. General information

NPI: 1558770867
Provider Name (Legal Business Name): FIRST CHOICE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2014
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 E JEFFERSON AVE
BASTROP LA
71220-4619
US

IV. Provider business mailing address

626 E JEFFERSON AVE
BASTROP LA
71220-4619
US

V. Phone/Fax

Practice location:
  • Phone: 318-239-2325
  • Fax: 318-239-2327
Mailing address:
  • Phone: 318-239-2325
  • Fax: 318-239-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: TONIA FREEMAN
Title or Position: COO
Credential:
Phone: 318-239-2325