MEDICARE: DISCOVERY COUNSELING LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1194263525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOVERY COUNSELING LLC

Provider Business Mailing Address
First Line	:	3005 19TH ST
Second Line	:	SUITE 700
City	:	COLUMBUS
State	:	NE
Zip	:	68601-4248
Country	:	US
Telephone Number	:	402-910-8216
Fax Number	:	402-910-8216

Provider Business Practice Location Address
First Line	:	3005 19TH ST
Second Line	:	SUITE 700
City	:	COLUMBUS
State	:	NE
Zip	:	68601-4248
Country	:	US
Telephone Number	:	402-910-8216
Fax Number	:	402-910-8216

Authorized Official
Title or Position	:	CLINIC ADMINISTRATOR
Name	:	TRACY L GOOS
Credential	:
Telephone Number	:	402-276-2363

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	02/06/2017

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Directions to “DISCOVERY COUNSELING LLC ” Practice Location

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