Healthcare Provider Details

I. General information

NPI: 1760801351
Provider Name (Legal Business Name): GRACE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 WALL ST
NORMAN OK
73069-6302
US

IV. Provider business mailing address

820 WALL ST
NORMAN OK
73069-6302
US

V. Phone/Fax

Practice location:
  • Phone: 405-928-2044
  • Fax: 405-928-2049
Mailing address:
  • Phone: 405-928-2044
  • Fax: 405-928-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2887
License Number StateOK

VIII. Authorized Official

Name: MRS. MORGAN LINN ROGERS
Title or Position: OWNER
Credential: LCSW
Phone: 405-928-2044