Provider Demographics
NPI:1184879652
Name:CHILDS, GRACE NELSON (LCSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:NELSON
Last Name:CHILDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 US HIGHWAY 1
Mailing Address - Street 2:SUITE 201-01
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2827
Mailing Address - Country:US
Mailing Address - Phone:561-818-1347
Mailing Address - Fax:
Practice Address - Street 1:11911 US HIGHWAY 1
Practice Address - Street 2:SUITE 201-01
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2827
Practice Address - Country:US
Practice Address - Phone:561-818-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW50941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical