=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629982178
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | I'M STILL STANDING BY GRACE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2026
-----------------------------------------------------
Last Update Date | 10/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 199 MARGATE DR
-----------------------------------------------------
City | GLEN BURNIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21060-7003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-831-0191
-----------------------------------------------------
Fax | 410-355-2350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 199 MARGATE DR
-----------------------------------------------------
City | GLEN BURNIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21060-7003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-831-0191
-----------------------------------------------------
Fax | 410-355-2350
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PAMELA RENEE DUKES
-----------------------------------------------------
Credential | LCPC, LCADC
-----------------------------------------------------
Telephone | 443-831-0191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------