Healthcare Provider Details

I. General information

NPI: 1932063567
Provider Name (Legal Business Name): GRACE GIVERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MADISON ST
ROCKY MOUNT NC
27801-5414
US

IV. Provider business mailing address

6069 BEALE LOOP
RALEIGH NC
27616-3473
US

V. Phone/Fax

Practice location:
  • Phone: 919-523-0863
  • Fax:
Mailing address:
  • Phone: 919-523-0863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: LATRICE M. PRINGLE
Title or Position: OWNER
Credential:
Phone: 919-523-0863