Healthcare Provider Details

I. General information

NPI: 1629439617
Provider Name (Legal Business Name): DISCOVERY COUNSELING AND ASSESSMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4006 HIGHWAY 34 E
SHARPSBURG GA
30277-3531
US

IV. Provider business mailing address

4006 HIGHWAY 34 E
SHARPSBURG GA
30277-3531
US

V. Phone/Fax

Practice location:
  • Phone: 404-960-1282
  • Fax: 855-817-2428
Mailing address:
  • Phone: 404-960-1282
  • Fax: 855-817-2428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRUCE N GRANT
Title or Position: LICENSED PSYCHOLOGIST
Credential: PSYD
Phone: 770-710-2173