Provider Demographics
NPI:1003237066
Name:GRACE-SANCHEZ, MEGANN E (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:MEGANN
Middle Name:E
Last Name:GRACE-SANCHEZ
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 ROUND KEEP LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8092
Mailing Address - Country:US
Mailing Address - Phone:704-663-4613
Mailing Address - Fax:
Practice Address - Street 1:913 N CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3414
Practice Address - Country:US
Practice Address - Phone:704-871-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0085631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical