Healthcare Provider Details

I. General information

NPI: 1629784335
Provider Name (Legal Business Name): DISCOVERING BEAUTIFUL MINDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/26/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 FAIRWAY DR
GRANITEVILLE SC
29829-4025
US

IV. Provider business mailing address

215 E BAY ST STE 201K
CHARLESTON SC
29401-2635
US

V. Phone/Fax

Practice location:
  • Phone: 803-392-3543
  • Fax:
Mailing address:
  • Phone: 803-392-3543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUNGERA CASH
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: BCBA, LPES
Phone: 803-392-3543