MEDICARE: C.H.O.I.C.E.S. INTERNATIONAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BP24000	OTHER	MD	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215387733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C.H.O.I.C.E.S. INTERNATIONAL

Provider Business Mailing Address
First Line	:	PO BOX 402
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20773-0402
Country	:	US
Telephone Number	:	240-389-4685
Fax Number	:

Provider Business Practice Location Address
First Line	:	9701 APOLLO DR
Second Line	:	330
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4783
Country	:	US
Telephone Number	:	240-389-4685
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	LACONYA REED
Credential	:	MA, LPC, LCPC, MAC
Telephone Number	:	240-389-4685

Provider Enumeration Date	:	06/15/2016
Last Update Date	:	06/15/2016

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