Provider Demographics
NPI:1043944424
Name:GANS, GRACE (LCSWA)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:GANS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:SANDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2015 WILSON ST, APT, SUITE, BLDG. (OPTIONAL), APT, SUIT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705
Mailing Address - Country:US
Mailing Address - Phone:919-323-7958
Mailing Address - Fax:
Practice Address - Street 1:288 EAST ST STE 1001-F7
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9711
Practice Address - Country:US
Practice Address - Phone:919-323-7958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical