Provider Demographics
NPI:1639746654
Name:GRACE, HOPE AND LOVE COUNSELING SERVICES
Entity Type:Organization
Organization Name:GRACE, HOPE AND LOVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DUNGEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-475-1512
Mailing Address - Street 1:3466 ELLENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7158
Mailing Address - Country:US
Mailing Address - Phone:804-475-1512
Mailing Address - Fax:
Practice Address - Street 1:3466 ELLENBROOK DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7158
Practice Address - Country:US
Practice Address - Phone:804-475-1512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)