Provider Demographics
NPI:1285071290
Name:HEALING GRACE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:HEALING GRACE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONEIS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:419-563-5434
Mailing Address - Street 1:354 ARCH DR
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3407
Mailing Address - Country:US
Mailing Address - Phone:419-562-3997
Mailing Address - Fax:
Practice Address - Street 1:354 ARCH DR
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3407
Practice Address - Country:US
Practice Address - Phone:419-562-3997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100071251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health