Healthcare Provider Details

I. General information

NPI: 1144091620
Provider Name (Legal Business Name): DISCOVERIES COUNSELING AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 TITUS AVE
ROCHESTER NY
14617-3939
US

IV. Provider business mailing address

572 TITUS AVE STE B
ROCHESTER NY
14617-3519
US

V. Phone/Fax

Practice location:
  • Phone: 585-766-3082
  • Fax: 585-386-1950
Mailing address:
  • Phone: 585-544-5342
  • Fax: 585-386-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. PEGGY SAMANTHA DERIVAN
Title or Position: PRESIDENT
Credential: LMHC
Phone: 585-766-3082