Provider Demographics
NPI:1851991160
Name:GRATIA COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:GRATIA COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:763-333-1553
Mailing Address - Street 1:2236 151ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-4624
Mailing Address - Country:US
Mailing Address - Phone:763-333-1553
Mailing Address - Fax:612-999-1993
Practice Address - Street 1:2705 BUNKER LAKE BLVD NW STE 103
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-3786
Practice Address - Country:US
Practice Address - Phone:763-333-1553
Practice Address - Fax:612-999-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)