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General NPI Number Information
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NPI Number | 1447508254
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Entity Type | Organization
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Legal Business Name | CHOICES COORDINATED CARE SOLUTIONS, INC.
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 7941 CASTLEWAY DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46250
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Country | US
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Telephone | 317-726-2121
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Fax | 866-849-3866
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Provider Business Mailing Address
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Address Line | 7941 CASTLEWAY DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46250
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Country | US
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Telephone | 317-726-2121
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Fax | 866-849-3866
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. MICHAEL GOLDBERG
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Credential |
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Telephone | 317-295-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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