Provider Demographics
NPI:1891183547
Name:GRACE PESIKEY INC.
Entity type:Organization
Organization Name:GRACE PESIKEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PESIKEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/CADC
Authorized Official - Phone:302-381-6648
Mailing Address - Street 1:32140 OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-3663
Mailing Address - Country:US
Mailing Address - Phone:302-381-6648
Mailing Address - Fax:
Practice Address - Street 1:19639 PLANTATIONS RD.
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-9999
Practice Address - Country:US
Practice Address - Phone:302-381-6648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00001491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty