Healthcare Provider Details

I. General information

NPI: 1811839293
Provider Name (Legal Business Name): GRACEFUL RESILIENCE COUNSELING & COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 WESTWOOD DR
STURBRIDGE MA
01566-1348
US

IV. Provider business mailing address

62 WESTWOOD DR
STURBRIDGE MA
01566-1348
US

V. Phone/Fax

Practice location:
  • Phone: 774-321-5620
  • Fax:
Mailing address:
  • Phone: 774-321-5620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOMARIE WATSON MALAVE
Title or Position: OWNER/PRE LICENSED MSW CLINICIAN
Credential:
Phone: 774-321-5620