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General NPI Number Information
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NPI Number | 1407521503
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Entity Type | Organization
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Legal Business Name | ESSENTIALLY GRACE COUNSELING
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 8813 N TARRANT PKWY STE 304
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-8461
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Country | US
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Telephone | 817-919-3185
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 SHEFFIELD PL
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City | FORT WORTH
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State | TX
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Zip | 76112-4097
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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 | PROFESSIONAL COUNSELOR
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Name | MS. DENEE' CANADY
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Credential | LPC
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Telephone | 817-919-3185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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