Provider Demographics
NPI:1912528381
Name:GRACE COUNSELING & CONSULTATION SERVICES, LLC
Entity type:Organization
Organization Name:GRACE COUNSELING & CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, NCC
Authorized Official - Phone:256-684-2462
Mailing Address - Street 1:650 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8621
Mailing Address - Country:US
Mailing Address - Phone:256-684-2462
Mailing Address - Fax:
Practice Address - Street 1:650 SUN TEMPLE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8621
Practice Address - Country:US
Practice Address - Phone:256-684-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700144979OtherNPI