Provider Demographics
NPI:1962928143
Name:DISCOVERIES GROUP AND INDIVIDUAL COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:DISCOVERIES GROUP AND INDIVIDUAL COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSWAIC
Authorized Official - Phone:509-730-5189
Mailing Address - Street 1:1011 E SHARPSBURG AVE APT 505
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-2610
Mailing Address - Country:US
Mailing Address - Phone:509-730-5189
Mailing Address - Fax:
Practice Address - Street 1:1100 W 6TH AVE STE A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3104
Practice Address - Country:US
Practice Address - Phone:509-740-3090
Practice Address - Fax:509-278-4961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60509943261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health