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General NPI Number Information
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NPI Number | 1093605610
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Entity Type | Organization
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Legal Business Name | GRACE AND GROWTH MENTAL WELLNESS
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 11815 FOUNTAIN WAY STE 300
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4448
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Country | US
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Telephone | 757-991-1503
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Fax | 757-941-7473
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Provider Business Mailing Address
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Address Line | PO BOX 7035
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City | HAMPTON
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State | VA
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Zip | 23666-0035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KEISHA DAWKINS
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Credential | NP
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Telephone | 757-991-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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