Provider Demographics
NPI:1649679101
Name:SCHENKEL, GRACE K (LLMSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:K
Last Name:SCHENKEL
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:K
Other - Last Name:DONNELLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:7018 BISON ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2805
Mailing Address - Country:US
Mailing Address - Phone:734-799-3284
Mailing Address - Fax:
Practice Address - Street 1:26300 OUTER DR
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2019
Practice Address - Country:US
Practice Address - Phone:734-785-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker