Provider Demographics
NPI:1629203906
Name:THE DISCOVERY PLACE OF HIGH POINT, NC
Entity Type:Organization
Organization Name:THE DISCOVERY PLACE OF HIGH POINT, NC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRAH
Authorized Official - Middle Name:P
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-883-0275
Mailing Address - Street 1:1114 TANGLE LN
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9141
Mailing Address - Country:US
Mailing Address - Phone:336-883-0275
Mailing Address - Fax:336-889-7005
Practice Address - Street 1:1114 TANGLE LN
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9141
Practice Address - Country:US
Practice Address - Phone:336-883-0275
Practice Address - Fax:336-889-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005841Medicaid