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General NPI Number Information
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NPI Number | 1912524539
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Entity Type | Individual
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Provider Name | GRACE K KRESS LPC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 6140 S BROADWAY
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City | LORAIN
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State | OH
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Zip | 44053-3891
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Country | US
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Telephone | 440-233-7232
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Fax | 440-204-4315
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Provider Business Mailing Address
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Address Line | 6140 S BROADWAY
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City | LORAIN
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State | OH
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Zip | 44053-3891
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Country | US
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Telephone | 440-233-7232
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Fax | 440-204-4315
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | C.2002427-TRNE
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.2103149
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License Number State | OH
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