Grace Clinical Counseling Centre, Inc

LBN: Grace Clinical Counseling Centre, Inc
Grace Clinical Counseling Centre, Inc is an health care organization with primary practice located at 5062 N 19Th Ave Ste 100 , Phoenix AZ 85015-3225. The organization recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator, Allopathic & Osteopathic Physicians / Addiction Medicine, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Ambulatory Health Care Facilities / Adult Mental Health is the primary health care specialty. Grace Clinical Counseling Centre, Inc can be contacted via phone (602) 855-0002, or through Burgess, Wildine via phone (240) 350-2863.

Contact Information

Primary practice address
5062 N 19Th Ave Ste 100 Phoenix AZ 85015-3225
Phone: (602) 855-0002
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Burgess, Wildine
Phone: (240) 350-2863

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1174281463
LBN Legal business name Grace Clinical Counseling Centre, Inc
DBA Doing business as
Authorized official Burgess, Wildine
Entity Organization
Organization subpart 1 No
Enumeration date Dec 3rd, 2021
Last updated Dec 3rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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