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General NPI Number Information
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NPI Number | 1639616170
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Entity Type | Organization
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Legal Business Name | CHOICE COUNSELING AND CONSULTING, INC.
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 13221 FORESTVIEW LN
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City | CRESTWOOD
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State | IL
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Zip | 60445-1307
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Country | US
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Telephone | 708-712-0747
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Fax | 708-926-2096
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Provider Business Mailing Address
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Address Line | 13221 FORESTVIEW LN
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City | CRESTWOOD
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State | IL
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Zip | 60445-1307
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Country | US
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Telephone | 708-712-0747
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Fax | 708-926-2096
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA A SMURZYNSKI
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Credential | LCPC
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Telephone | 708-712-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 180008555
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License Number State | IL
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