Healthcare Provider Details

I. General information

NPI: 1922913904
Provider Name (Legal Business Name): HEALING GRACE COUNSELING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 LONG PRAIRIE RD
FLOWER MOUND TX
75022-4845
US

IV. Provider business mailing address

PO BOX 9864
LONGVIEW TX
75608-9864
US

V. Phone/Fax

Practice location:
  • Phone: 940-268-5406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID MILLER
Title or Position: CO-OWNER
Credential: LPC
Phone: 903-402-5663