Healthcare Provider Details

I. General information

NPI: 1356022180
Provider Name (Legal Business Name): AMAZING GRACE COUNSELING & CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 AL HIGHWAY 20
TOWN CREEK AL
35672-3845
US

IV. Provider business mailing address

1712 COUNTY ROAD 265
TOWN CREEK AL
35672-4244
US

V. Phone/Fax

Practice location:
  • Phone: 256-602-1787
  • Fax:
Mailing address:
  • Phone: 256-565-7685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUTHIE L JONES
Title or Position: OWNER
Credential: LICSW
Phone: 256-565-7685