MEDICARE: MS. CAROLYN HONEA GRACE LCSW, DCSW, ACHI

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	104100000X	Social Worker	S16636	TX

General Provider Information

NPI Number	:	1831441740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLYN HONEA GRACE LCSW, DCSW, ACHI

Provider Business Mailing Address
First Line	:	P.O. BOX 35501
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77235-5501
Country	:	US
Telephone Number	:	713-278-8180
Fax Number	:	713-729-5853

Provider Business Practice Location Address
First Line	:	5120 WOODWAY DRIVE, SUITE 9015
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-5322
Country	:	US
Telephone Number	:	713-278-8180
Fax Number	:	713-729-5853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2012
Last Update Date	:	10/03/2012

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