Healthcare Provider Details

I. General information

NPI: 1477482388
Provider Name (Legal Business Name): KALEBS GRACE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BAY ST STE 2B
BEAUFORT SC
29902-5569
US

IV. Provider business mailing address

100 STUART TOWNE LN APT 14B
PORT ROYAL SC
29935-1727
US

V. Phone/Fax

Practice location:
  • Phone: 843-473-7764
  • Fax:
Mailing address:
  • Phone: 843-422-3750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ZARISA WATKINS
Title or Position: OWNER
Credential: MA, LPC, NCC
Phone: 843-422-3750