Healthcare Provider Details

I. General information

NPI: 1144146903
Provider Name (Legal Business Name): COMMON GRACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 GREENTREE CIR
AURORA OH
44202-7904
US

IV. Provider business mailing address

240 GREENTREE CIR
AURORA OH
44202-7904
US

V. Phone/Fax

Practice location:
  • Phone: 440-313-5958
  • Fax:
Mailing address:
  • Phone: 440-313-5958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARIA PASTVA
Title or Position: OPERATOR
Credential: LISW-S
Phone: 440-313-5958