Provider Demographics
NPI:1366126997
Name:THERAPEUTIC CHOICES
Entity type:Organization
Organization Name:THERAPEUTIC CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROGRAM MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:STOUT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-338-5836
Mailing Address - Street 1:1973 TRUMPET DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-7948
Mailing Address - Country:US
Mailing Address - Phone:530-338-5836
Mailing Address - Fax:
Practice Address - Street 1:1484 HARTNELL AVE STE G
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2254
Practice Address - Country:US
Practice Address - Phone:530-338-5836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)