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General NPI Number Information
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NPI Number | 1962945600
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Entity Type | Organization
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Legal Business Name | GRACE COUNSELING & SERVICES LLC
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 306 7TH AVE NW
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City | ATTALLA
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State | AL
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Zip | 35954-2048
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Country | US
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Telephone | 256-295-7402
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Fax |
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Provider Business Mailing Address
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Address Line | 105 CEDAR LN
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City | ATTALLA
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State | AL
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Zip | 35954-8935
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Country | US
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Telephone | 256-295-7402
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MRS. RENEE MICHELLE BELLEW
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Credential | LICSW
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Telephone | 256-295-7402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1273-3856C
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License Number State | AL
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