Healthcare Provider Details

I. General information

NPI: 1770419939
Provider Name (Legal Business Name): HANNAH RAE GRACY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 ANDERSON AVE STE D110
MANHATTAN KS
66503-7603
US

IV. Provider business mailing address

4201 ANDERSON AVE STE D110
MANHATTAN KS
66503-7603
US

V. Phone/Fax

Practice location:
  • Phone: 785-539-5455
  • Fax:
Mailing address:
  • Phone: 785-539-5455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT03867
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: