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General NPI Number Information
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NPI Number | 1376217810
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Entity Type | Organization
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Legal Business Name | PLENTY AND GRACE COUNSELING SERVICES
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Dates
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Enumeration Date | 08/07/2021
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Last Update Date | 08/07/2021
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Provider Practice Location Address
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Address Line | 2525 RAEFORD RD STE C
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5092
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Country | US
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Telephone | 910-309-6569
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Fax |
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Provider Business Mailing Address
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Address Line | 7917 LESTER DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-7420
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Country | US
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Telephone | 808-349-4163
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACEY R FRINK
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Credential | M.DIV, LMFT-S, CST
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Telephone | 910-309-6569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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