Provider Demographics
NPI:1497375380
Name:DISCOVERY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:DISCOVERY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASTERS SOCIAL WORKER/OWNE
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VEDIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:906-828-5118
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-0842
Mailing Address - Country:US
Mailing Address - Phone:906-828-5118
Mailing Address - Fax:
Practice Address - Street 1:333 S STEPHENSON AVE # 203
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-2942
Practice Address - Country:US
Practice Address - Phone:906-828-5118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty