Provider Demographics
NPI:1437816220
Name:DISCOVER AND RESTORE, PLLC
Entity Type:Organization
Organization Name:DISCOVER AND RESTORE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-287-5979
Mailing Address - Street 1:5 FARM PONDS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-1743
Mailing Address - Country:US
Mailing Address - Phone:860-287-5979
Mailing Address - Fax:
Practice Address - Street 1:11 MAIN ST
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-3654
Practice Address - Country:US
Practice Address - Phone:860-287-5979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty