Provider Demographics
NPI:1164015418
Name:ARMSTRONG, GRACE KATHERINE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:KATHERINE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 CHATEAU ROYALE CT
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1819
Mailing Address - Country:US
Mailing Address - Phone:304-288-0175
Mailing Address - Fax:
Practice Address - Street 1:1126 PEARWAY LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3221
Practice Address - Country:US
Practice Address - Phone:304-288-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2106329104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker