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General NPI Number Information
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NPI Number | 1376258764
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Entity Type | Organization
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Legal Business Name | BY GRACE COUNSELING AND CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 150 W SECTION AVE STE 101
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City | FOLEY
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State | AL
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Zip | 36535-3570
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Country | US
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Telephone | 575-202-2375
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Fax |
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Provider Business Mailing Address
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Address Line | 25620 COUNTY ROAD 65
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City | LOXLEY
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State | AL
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Zip | 36551-7622
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Country | US
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Telephone | 575-202-2376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BEATRIZ G. FAVELA
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Credential | LICSW
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Telephone | 575-202-2376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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