ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC NPI 1053275206

NPI Information

NPI: 1053275206
Provider Name: ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC
Classification: Health and Wellness Coach - 171400000X
Entity Type: Organization
Address: 5736 N TRYON ST STE 125A
CHARLOTTE, NC
ZIP 28213
Phone: (704) 713-5652

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NPI Details

ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC is a health and wellness coach in Charlotte, NC. The provider is the Health & Wellness Coach is trained in motivational theories, strategies, and communication techniques, which are used to assist patients to develop intrinsic motivation and obtain skills to create sustainable change for improved health and well-being. Health and wellness coaching is a patient-centered approach wherein patients at least partially determine their goals, use self-discovery or active learning processes together with content education to work toward their goals, and self-monitor behaviors to increase accountability, all within the context of an interpersonal relationship with a coach. ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC NPI is 1053275206. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5736 N TRYON ST STE 125A
CHARLOTTE, NC
ZIP 28213-886
Phone: (704) 713-5652

The provider's authorized official is Lastarra Shawnta Mcdonald .
The authorized official title is Ceo and has the following contact phone number (704) 819-1965.

The enumeration date for this NPI number is 12/11/2025 and was last updated on 12/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	347C00000X	Private Vehicle		No
3	174200000X	Meals		No
4	175T00000X	Peer Specialist		No
5	251S00000X	Community/Behavioral Health		No
6	252Y00000X	Early Intervention Provider Agency		No
7	253Z00000X	In Home Supportive Care		No
8	171M00000X	Case Manager/Care Coordinator		No
9	101YM0800X	Counselor	Mental Health	No
10	103T00000X	Psychologist		No
11	1041C0700X	Social Worker	Clinical	No
12	106S00000X	Behavior Technician		No
13	372600000X	Adult Companion		No
14	374U00000X	Home Health Aide		No
15	171400000X	Health and Wellness Coach		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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