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General NPI Number Information
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NPI Number | 1376742486
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Entity Type | Organization
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Legal Business Name | DISCOVERY COUNSELING
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 1406 S MAIN ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2532
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Country | US
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Telephone | 434-808-2637
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Fax | 434-505-0111
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Provider Business Mailing Address
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Address Line | 1406 S MAIN ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2532
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Country | US
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Telephone | 434-808-2637
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Fax | 434-505-0111
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DENNIS GOWIN
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Credential | LMHC
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Telephone | 434-808-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004772
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License Number State | VA
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