GRACE CLINICAL COUNSELING CENTRE INC NPI 1174281463

NPI Information

  • NPI: 1174281463
  • Provider Name: GRACE CLINICAL COUNSELING CENTRE, INC
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 5062 N 19TH AVE STE 100
    PHOENIX, AZ
    ZIP 85015
  • Phone: (602) 855-0002

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NPI Details

GRACE CLINICAL COUNSELING CENTRE, INC is an adult mental health clinic center in Phoenix, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. GRACE CLINICAL COUNSELING CENTRE, INC NPI is 1174281463. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5062 N 19TH AVE STE 100
PHOENIX, AZ
ZIP 85015-225
Phone: (602) 855-0002

The provider's authorized official is Wildine Burgess .
The authorized official title is Executive Administrator and has the following contact phone number (240) 350-2863.

The enumeration date for this NPI number is 12/3/2021 and was last updated on 12/3/2021.

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 License Number License State Primary
1101YM0800XCounselorMental HealthNo
22084A0401XPsychiatry & NeurologyAddiction MedicineNo
3261QM0850XClinic/CenterAdult Mental HealthYes
4261QP2300XClinic/CenterPrimary CareNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
6363LP2300XNurse PractitionerPrimary CareNo
7171M00000XCase Manager/Care CoordinatorNo

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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