Provider Demographics
NPI:1114765203
Name:GEISLER, GRACE ELAINE (LPC)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:ELAINE
Last Name:GEISLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-2017
Mailing Address - Country:US
Mailing Address - Phone:334-791-2479
Mailing Address - Fax:
Practice Address - Street 1:634 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:HEADLAND
Practice Address - State:AL
Practice Address - Zip Code:36345-2017
Practice Address - Country:US
Practice Address - Phone:334-791-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL05078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health