Provider Demographics
NPI:1285002881
Name:GRACE COUNSELING
Entity Type:Organization
Organization Name:GRACE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAMARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CAADC, ADS
Authorized Official - Phone:517-285-0015
Mailing Address - Street 1:6196 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1546
Mailing Address - Country:US
Mailing Address - Phone:517-285-0019
Mailing Address - Fax:
Practice Address - Street 1:6196 PORTER AVE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1546
Practice Address - Country:US
Practice Address - Phone:517-285-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty