Healthcare Provider Details

I. General information

NPI: 1063931764
Provider Name (Legal Business Name): DISCOVERY COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 MAIN ST
DANIELSON CT
06239-2816
US

IV. Provider business mailing address

239 MAIN ST
DANIELSON CT
06239-2816
US

V. Phone/Fax

Practice location:
  • Phone: 203-907-9552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1922
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH RICHARDS
Title or Position: MANAGING MEMBER
Credential: LMFT
Phone: 203-907-9552