=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508703042
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DISCREET THERAPY SERVICES LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2026
-----------------------------------------------------
Last Update Date | 05/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7167 HIGHWAY 38
-----------------------------------------------------
City | EVARTS
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40828-6331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-795-5443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7167 HIGHWAY 38
-----------------------------------------------------
City | EVARTS
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40828-6331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-795-5443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/COUNSELOR
-----------------------------------------------------
Name | MR. GUADALUPE BLAS III
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 606-795-5443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------