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General NPI Number Information
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NPI Number | 1629784335
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Entity Type | Organization
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Legal Business Name | DISCOVERING BEAUTIFUL MINDS, LLC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 303 FAIRWAY DR
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City | GRANITEVILLE
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State | SC
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Zip | 29829-4025
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Country | US
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Telephone | 803-392-3543
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E BAY ST STE 201K
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City | CHARLESTON
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State | SC
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Zip | 29401-2635
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Country | US
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Telephone | 803-392-3543
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | MUNGERA CASH
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Credential | BCBA, LPES
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Telephone | 803-392-3543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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