| Grace Counseling And Wellness, Pllc | |
|
2224 Lacy St Burlington NC 27215-5341 | |
| (336) 494-5743 | |
| (866) 278-9217 |
| Full Name | Grace Counseling And Wellness, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 2224 Lacy St, Burlington, North Carolina |
| Authorized Official Name and Position | Sation Konchellah (COUNSELOR/OWNER) |
| Authorized Official Contact | 3364945743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Counseling And Wellness, Pllc Po Box 122 Sedalia NC 27342-0122 Ph: (336) 494-5743 | Grace Counseling And Wellness, Pllc 2224 Lacy St Burlington NC 27215-5341 Ph: (336) 494-5743 |
| NPI Number | 1376068528 |
|---|---|
| Provider Enumeration Date | 08/09/2017 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 3476905167 |
|---|---|
| Medicare Enrollment ID | O20240118001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376068528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Sation Konchellah |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144613043 PECOS PAC ID: 6103278890 Enrollment ID: I20240118001103 |
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