Provider Demographics
NPI:1437781770
Name:GRACIOUS COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:GRACIOUS COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:407-572-9345
Mailing Address - Street 1:5268 WELLINGTON PARK CIR APT A25
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-4623
Mailing Address - Country:US
Mailing Address - Phone:407-572-9345
Mailing Address - Fax:
Practice Address - Street 1:670 N ORLANDO AVE STE 103
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4465
Practice Address - Country:US
Practice Address - Phone:321-804-1439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty