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General NPI Number Information
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NPI Number | 1679461230
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Entity Type | Organization
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Legal Business Name | COUNSELING BY GRACE
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 5401 S SHERIDAN RD STE 401
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City | TULSA
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State | OK
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Zip | 74145-7530
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Country | US
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Telephone | 918-212-8361
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Fax |
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Provider Business Mailing Address
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Address Line | 5401 S SHERIDAN RD STE 401
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City | TULSA
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State | OK
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Zip | 74145-7530
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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 | LPC/OWNER
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Name | GRACIE JAMISON
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Credential |
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Telephone | 405-596-7947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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