MEDICARE: GRACEWOVEN COUNSELING, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1669331294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEWOVEN COUNSELING, LLC

Provider Business Mailing Address
First Line	:	7519 HARBOUR TOWN DR
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-8665
Country	:	US
Telephone Number	:	480-540-5701
Fax Number	:

Provider Business Practice Location Address
First Line	:	7519 HARBOUR TOWN DR
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-8665
Country	:	US
Telephone Number	:	480-540-5701
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LPCC
Name	:	MR. CHRISTOPHER RICHARD ELDRIDGE
Credential	:	LPCC
Telephone Number	:	480-540-5701

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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