Healthcare Provider Details

I. General information

NPI: 1942786793
Provider Name (Legal Business Name): DISCOVERING HOPE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9480 HIGHWAY 805
JENKINS KY
41537-8182
US

IV. Provider business mailing address

PO BOX 983
CLINTWOOD VA
24228-0983
US

V. Phone/Fax

Practice location:
  • Phone: 276-639-0077
  • Fax:
Mailing address:
  • Phone: 276-639-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW JUSTIN BAKER ROSE
Title or Position: CEO/LEAD CLINICIAN
Credential: TCADC
Phone: 276-639-0077