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1629841473 NPI number — GRIT AND GRACE COUNSELING SERVICES, LLC

NPI Number: 1629841473
Health Care Provider/Practitioner: GRIT AND GRACE COUNSELING SERVICES, LLC

Information about “1629841473” NPI (GRIT AND GRACE COUNSELING SERVICES, LLC) exists in 1629841473 in HTML format HTML  |  1629841473 in plain Text format TXT  |  1629841473 in PDF (Portable Document Format) PDF  |  1629841473 in an XML format XML  formats.

NPI Number : 1629841473 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629841473",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GRIT AND GRACE COUNSELING SERVICES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3832-10 BAYMEADOWS RD # 134",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32217-5606",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "850-590-7098",
    "MailingAddressFaxNumber": "904-299-9985",
    "FirstLinePracticeLocationAddress": "3840-1 WILLIAMSBURG PARK BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32257-9245",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-299-9589",
    "PracticeLocationAddressFaxNumber": "904-299-9985",
    "EnumerationDate": "11/02/2023",
    "LastUpdateDate": "01/22/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GRIFFITH",
    "AuthorizedOfficialFirstName": "TARA",
    "AuthorizedOfficialMiddleName": "MARIE",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "850-590-7098",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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