Healthcare Provider Details

I. General information

NPI: 1821903667
Provider Name (Legal Business Name): AMAZING GRACE MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 KENLY AVE
HAGERSTOWN MD
21740
US

IV. Provider business mailing address

41 DISTANT VIEW DR
HEDGESVILLE WV
25427-7814
US

V. Phone/Fax

Practice location:
  • Phone: 973-980-3885
  • Fax:
Mailing address:
  • Phone: 973-980-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAMEKA DAWKINS
Title or Position: NURSE PRACTITIONER
Credential: PMHNP-BC
Phone: 973-980-3885