Provider Demographics
NPI:1558548479
Name:DISCOVERY COUNSELING SERVICES
Entity Type:Organization
Organization Name:DISCOVERY COUNSELING SERVICES
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HIRST, LCSW,DCSW,ACSW
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER OF SOCIAL WOR
Authorized Official - Phone:318-424-1322
Mailing Address - Street 1:820 JORDAN ST
Mailing Address - Street 2:SUITE 510-G
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4518
Mailing Address - Country:US
Mailing Address - Phone:318-424-1322
Mailing Address - Fax:318-742-5981
Practice Address - Street 1:820 JORDAN ST
Practice Address - Street 2:SUITE 510-G
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4518
Practice Address - Country:US
Practice Address - Phone:318-424-1322
Practice Address - Fax:318-742-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3129251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health