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General NPI Number Information
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NPI Number | 1982316303
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Entity Type | Organization
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Legal Business Name | GRACE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 10707 66TH ST N STE 9
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2336
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Country | US
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Telephone | 727-314-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 10707 66TH ST N STE 9
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2336
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Country | US
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Telephone | 727-314-5001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERTO ALVES
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Credential | PSYD
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Telephone | 727-314-5001
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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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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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