Healthcare Provider Details

I. General information

NPI: 1508703042
Provider Name (Legal Business Name): DISCREET THERAPY SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7167 HIGHWAY 38
EVARTS KY
40828-6331
US

IV. Provider business mailing address

7167 HIGHWAY 38
EVARTS KY
40828-6331
US

V. Phone/Fax

Practice location:
  • Phone: 606-795-5443
  • Fax:
Mailing address:
  • Phone: 606-795-5443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. GUADALUPE BLAS III
Title or Position: OWNER/COUNSELOR
Credential: LPCC
Phone: 606-795-5443