Healthcare Provider Details
I. General information
NPI: 1316124019
Provider Name (Legal Business Name): DISCOVERY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/24/2008
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
296 S MAIN ST
BRITTON MI
49229-9797
US
IV. Provider business mailing address
260 S MAIN ST
BRITTON MI
49229-9797
US
V. Phone/Fax
- Phone: 517-488-2545
- Fax: 517-451-5415
- Phone: 517-488-2545
- Fax: 517-451-5415
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 6301013432 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 6301013432 |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
ROBERT
LYNN
WRIGHT
Title or Position: DIRECTOR
Credential: MACP LLP
Phone: 517-488-2545