Provider Demographics
NPI:1891975793
Name:KARIUKI, GRACE W (LCPC)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:W
Last Name:KARIUKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 BICKNELL RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN HEAD
Mailing Address - State:MD
Mailing Address - Zip Code:20640-3417
Mailing Address - Country:US
Mailing Address - Phone:240-435-8114
Mailing Address - Fax:301-609-7284
Practice Address - Street 1:6035 BICKNELL RD
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-3417
Practice Address - Country:US
Practice Address - Phone:240-435-8114
Practice Address - Fax:301-609-7284
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDLC3099101YP2500X
NC6816101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103748Medicaid