Healthcare Provider Details

I. General information

NPI: 1972996387
Provider Name (Legal Business Name): GRACE ABOUNDS COUNSELING & PSYCHOLOGICAL CONSULTING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 ROUTE 34
MATAWAN NJ
07747-2132
US

IV. Provider business mailing address

114 STATE ROUTE 34
MATAWAN NJ
07747-2132
US

V. Phone/Fax

Practice location:
  • Phone: 732-696-8162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00483400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. FELICIA ETUKE
Title or Position: LICENSE PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 732-696-8162