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NPI Code Detail

MEDICARE: TRACY L. GRANT- COUNSELING FOR WOMEN, LLC

MEDICARE: TRACY L. GRANT- COUNSELING FOR WOMEN, 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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1821698382
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRACY L. GRANT- COUNSELING FOR WOMEN, LLC
Provider Business Mailing Address
First Line : 312 GRANITE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23226-2144
Country : US
Telephone Number : 804-244-3345
Fax Number : 804-373-2704
Provider Business Practice Location Address
First Line : 312 GRANITE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23226-2144
Country : US
Telephone Number : 804-244-3345
Fax Number : 804-373-2704
Authorized Official
Title or Position : PRESIDENT
Name : MS. TRACY LYNNE GRANT
Credential : LPC
Telephone Number : 804-244-3345
Provider Enumeration Date : 10/26/2020
Last Update Date : 10/26/2020

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