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General NPI Number Information
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NPI Number | 1518548049
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Entity Type | Organization
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Legal Business Name | GRACIOUS MIND COUNSELING AND WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 608 E HICKORY ST STE 128
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City | DENTON
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State | TX
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Zip | 76205-4311
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Country | US
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Telephone | 940-228-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 4504 MERCHANT TRL
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City | DENTON
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State | TX
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Zip | 76207-1578
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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 | OWNER
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Name | KAREN MCDOWELL
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Credential |
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Telephone | 940-228-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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