MEDICARE: MS. GRACE STERLING L.P.C., LCADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	37LC00092300	NJ
2	101YP2500X	Professional Counselor	37PC00044700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10766216	OTHER	NJ	CAQH

General Provider Information

NPI Number	:	1477691392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GRACE STERLING L.P.C., LCADC

Provider Business Mailing Address
First Line	:	942 W LAKE AVE
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-1620
Country	:	US
Telephone Number	:	973-476-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	2816 MORRIS AVE
Second Line	:	LOWER LEVEL
City	:	UNION
State	:	NJ
Zip	:	07083-4849
Country	:	US
Telephone Number	:	908-687-8088
Fax Number	:	908-687-8066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	06/13/2023

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Directions to “ MS. GRACE STERLING L.P.C., LCADC” Practice Location

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