Basic Information
| Provider Information | |||||||||
| NPI: | 1548711260 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRST CHOICE COUNSELING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1702 GLENBOURNE AVE | ||||||||
| Address2: | APT. 202 | ||||||||
| City: | BASTROP | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712201904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185575000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 644 E JEFFERSON AVE | ||||||||
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| City: | BASTROP | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712204619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182393862 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2016 | ||||||||
| LastUpdateDate: | 10/18/2016 | ||||||||
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| AuthorizedOfficialLastName: | BRAZZEL | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3182393862 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LPC, LMFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
No ID Information.