Provider Demographics
NPI:1083877229
Name:BRACE, GRACE H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:H
Last Name:BRACE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:GARDOMER
Mailing Address - State:ME
Mailing Address - Zip Code:04345
Mailing Address - Country:US
Mailing Address - Phone:207-588-0235
Mailing Address - Fax:207-582-9027
Practice Address - Street 1:418 WATER ST
Practice Address - Street 2:
Practice Address - City:GARDOMER
Practice Address - State:ME
Practice Address - Zip Code:04345
Practice Address - Country:US
Practice Address - Phone:207-588-0235
Practice Address - Fax:207-582-9027
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker