Provider Demographics
NPI:1184339434
Name:GRIFFIN-SPAIN, GRACE SAKOULAS (MA, PLPC, LPC)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:SAKOULAS
Last Name:GRIFFIN-SPAIN
Suffix:
Gender:F
Credentials:MA, PLPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 ROANOKE PKWY APT 705
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1672
Mailing Address - Country:US
Mailing Address - Phone:913-544-4642
Mailing Address - Fax:
Practice Address - Street 1:124 MISSOURI AVE STE 200
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1499
Practice Address - Country:US
Practice Address - Phone:816-423-2593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021840944101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional