MEDICARE: GRIT AND GRACE COUNSELING SERVICES, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1629841473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIT AND GRACE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	3832-10 BAYMEADOWS RD # 134
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-5606
Country	:	US
Telephone Number	:	850-590-7098
Fax Number	:	904-299-9985

Provider Business Practice Location Address
First Line	:	3840-1 WILLIAMSBURG PARK BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-9245
Country	:	US
Telephone Number	:	904-299-9589
Fax Number	:	904-299-9985

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TARA MARIE GRIFFITH
Credential	:	LCSW
Telephone Number	:	850-590-7098

Provider Enumeration Date	:	11/02/2023
Last Update Date	:	01/22/2026

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