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NPI Code Detail

MEDICARE: DISCOVERY INSTITUTE, P.A.

MEDICARE: DISCOVERY INSTITUTE, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH3802FL

General Provider Information

NPI Number : 1295706877
Entity Type Code : Organization
Provider Name (Legal Business Name) : DISCOVERY INSTITUTE, P.A.
Provider Business Mailing Address
First Line : PO BOX 560875
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32956-0875
Country : US
Telephone Number : 321-631-5538
Fax Number : 321-631-5154
Provider Business Practice Location Address
First Line : 4175 S. HWY. 1
Second Line : SUITE 102
City : ROCKLEDGE
State : FL
Zip : 32955-3528
Country : US
Telephone Number : 321-631-5538
Fax Number : 321-631-5154
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : CONNIE PORTER-RICHARD
Credential : PHD, LMHC
Telephone Number : 321-631-5538
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/19/2014

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Directions to “DISCOVERY INSTITUTE, P.A. ” Practice Location

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