GRACE CLINICAL COUNSELING CENTRE INC NPI 1174281463

NPI Information

NPI: 1174281463
Provider Name: GRACE CLINICAL COUNSELING CENTRE, INC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
5062 N 19TH AVE STE 100
PHOENIX, AZ
ZIP 85015
Phone: (602) 855-0002
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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	Primary
1	101YM0800X	Counselor	Mental Health	No
2	2084A0401X	Psychiatry & Neurology	Addiction Medicine	No
3	261QM0850X	Clinic/Center	Adult Mental Health	Yes
4	261QP2300X	Clinic/Center	Primary Care	No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
6	363LP2300X	Nurse Practitioner	Primary Care	No
7	171M00000X	Case Manager/Care Coordinator		No

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: 4/28/2024

NPI Synchronization or Removal

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