Provider Demographics
NPI:1144091620
Name:DISCOVERIES COUNSELING AND WELLNESS CENTER
Entity type:Organization
Organization Name:DISCOVERIES COUNSELING AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:DERIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:585-766-3082
Mailing Address - Street 1:572 TITUS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3519
Mailing Address - Country:US
Mailing Address - Phone:585-544-5342
Mailing Address - Fax:585-386-1950
Practice Address - Street 1:644 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3939
Practice Address - Country:US
Practice Address - Phone:585-766-3082
Practice Address - Fax:585-386-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)