Provider Demographics
NPI:1942731773
Name:GRACE PSYCHOLOGICAL HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:GRACE PSYCHOLOGICAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST, LPC
Authorized Official - Prefix:DR
Authorized Official - First Name:LARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STARLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-501-7362
Mailing Address - Street 1:PO BOX 151262
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-7262
Mailing Address - Country:US
Mailing Address - Phone:817-501-7362
Mailing Address - Fax:888-627-2461
Practice Address - Street 1:901 W BARDIN RD STE 102
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-6000
Practice Address - Country:US
Practice Address - Phone:817-501-7362
Practice Address - Fax:888-627-2461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67564101YP2500X
TX36475103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty