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General NPI Number Information
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NPI Number | 1023697745
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Entity Type | Organization
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Legal Business Name | DISCOVERY MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 13453 N MAIN ST STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32218-2773
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Country | US
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Telephone | 904-773-4390
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Fax | 941-621-7089
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Provider Business Mailing Address
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Address Line | 13453 N MAIN ST STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32218-2773
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Country | US
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Telephone | 904-773-4390
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Fax | 941-621-7089
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KELLY LANE STEVENS
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Credential | LMFT
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Telephone | 904-294-6277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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