Healthcare Provider Details

I. General information

NPI: 1720972466
Provider Name (Legal Business Name): AMAZING GRACE COACHING & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 50TH ST NE
BELGRADE MN
56312-9134
US

IV. Provider business mailing address

PO BOX 243
NEW LONDON MN
56273-0243
US

V. Phone/Fax

Practice location:
  • Phone: 320-429-1735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: REBECCA SARSLAND
Title or Position: OWNER
Credential: LICSW
Phone: 320-441-9226