Provider Demographics
NPI:1831820166
Name:HOCKENBERRY, GRACE (RMHCI)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:HOCKENBERRY
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:NIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:443 HARBOR WINDS CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 LOOKOUT PL STE 202
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4485
Practice Address - Country:US
Practice Address - Phone:407-537-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health