Provider Demographics
NPI:1639325871
Name:GUIDING GRACE COUNSELING LLC
Entity Type:Organization
Organization Name:GUIDING GRACE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, CTT
Authorized Official - Phone:330-343-7400
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-0534
Mailing Address - Country:US
Mailing Address - Phone:330-343-7400
Mailing Address - Fax:330-343-7414
Practice Address - Street 1:547 1/2 S JAMES ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2137
Practice Address - Country:US
Practice Address - Phone:330-343-7400
Practice Address - Fax:330-343-7414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty