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General NPI Number Information
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NPI Number | 1417328477
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Entity Type | Organization
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Legal Business Name | GRACE COUNSELING, INC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 34474 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-2003
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Country | US
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Telephone | 586-996-2273
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Fax | 586-725-6477
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Provider Business Mailing Address
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Address Line | 34474 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-2003
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Country | US
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Telephone | 586-996-2273
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Fax | 586-725-6477
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Authorized Official
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Title or Position | DIRECTOR / COUNSELOR
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Name | GAIL SUZANNE SEBREE
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Credential | MA, LPC
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Telephone | 586-996-2273
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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 | 6401011835
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License Number State | MI
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