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General NPI Number Information
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NPI Number | 1720972466
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Entity Type | Organization
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Legal Business Name | AMAZING GRACE COACHING & COUNSELING LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 25200 50TH ST NE
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City | BELGRADE
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State | MN
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Zip | 56312-9134
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Country | US
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Telephone | 320-429-1735
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 243
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City | NEW LONDON
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State | MN
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Zip | 56273-0243
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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 | REBECCA SARSLAND
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Credential | LICSW
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Telephone | 320-441-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 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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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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