Provider Demographics
NPI:1871383604
Name:THE GRACE GROUP
Entity type:Organization
Organization Name:THE GRACE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THER., PASTORAL COUN.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:VIRGINIA
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, CCPE, LCPC
Authorized Official - Phone:443-839-7464
Mailing Address - Street 1:5405 BALISTAN RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4505
Mailing Address - Country:US
Mailing Address - Phone:443-839-7464
Mailing Address - Fax:
Practice Address - Street 1:5405 BALISTAN RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4505
Practice Address - Country:US
Practice Address - Phone:443-839-7464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty