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General NPI Number Information
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NPI Number | 1821698382
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Entity Type | Organization
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Legal Business Name | TRACY L. GRANT- COUNSELING FOR WOMEN, LLC
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 312 GRANITE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2144
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Country | US
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Telephone | 804-244-3345
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Fax | 804-373-2704
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Provider Business Mailing Address
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Address Line | 312 GRANITE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2144
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Country | US
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Telephone | 804-244-3345
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Fax | 804-373-2704
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TRACY LYNNE GRANT
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Credential | LPC
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Telephone | 804-244-3345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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