Provider Demographics
NPI:1790375327
Name:GOOD GRACE COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:GOOD GRACE COUNSELING & CONSULTING LLC
Other - Org Name:GOOD GRACE COUNSELING & CONSULTING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,CAP
Authorized Official - Phone:307-321-3076
Mailing Address - Street 1:1212 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5209
Mailing Address - Country:US
Mailing Address - Phone:307-321-3076
Mailing Address - Fax:
Practice Address - Street 1:1410 W PINE ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5317
Practice Address - Country:US
Practice Address - Phone:307-321-3076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty