Healthcare Provider Details

I. General information

NPI: 1689585945
Provider Name (Legal Business Name): SUFFICIENT GRACE MENTAL HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3228 LAKESHORE DR
ANNA TX
75409-3670
US

IV. Provider business mailing address

3228 LAKESHORE DR
ANNA TX
75409-3670
US

V. Phone/Fax

Practice location:
  • Phone: 240-626-0607
  • Fax:
Mailing address:
  • Phone: 240-626-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSEPHINE CHANGNWIE VUCHANSU
Title or Position: OWNER
Credential:
Phone: 240-626-0607