Provider Demographics
NPI:1245411461
Name:GRACE COUNSELING GROUP
Entity type:Organization
Organization Name:GRACE COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:SCHOGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-598-5991
Mailing Address - Street 1:4132 KATELLA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3493
Mailing Address - Country:US
Mailing Address - Phone:562-598-5991
Mailing Address - Fax:562-598-5997
Practice Address - Street 1:4132 KATELLA AVE STE 104
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3493
Practice Address - Country:US
Practice Address - Phone:562-598-5991
Practice Address - Fax:562-598-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35972106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty