MEDICARE: GRACE AND HOPE COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457195505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE AND HOPE COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	8715 E 46TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-7101
Country	:	US
Telephone Number	:	918-947-9297
Fax Number	:

Provider Business Practice Location Address
First Line	:	13720 E 86TH ST N STE 170
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-8741
Country	:	US
Telephone Number	:	918-947-9297
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMARA LAAKSO
Credential	:	LPC
Telephone Number	:	918-947-9297

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	04/14/2026

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