Provider Demographics
NPI:1821568759
Name:GRACE THERAPEUTIC COUNSELING PLLC
Entity Type:Organization
Organization Name:GRACE THERAPEUTIC COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-421-5464
Mailing Address - Street 1:123 MULLINAX DR
Mailing Address - Street 2:
Mailing Address - City:GROVER
Mailing Address - State:NC
Mailing Address - Zip Code:28073-9584
Mailing Address - Country:US
Mailing Address - Phone:704-421-5464
Mailing Address - Fax:
Practice Address - Street 1:2020 REMOUNT RD STE E-102
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7476
Practice Address - Country:US
Practice Address - Phone:704-421-5464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health