| Grace Counseling Center | |
|
7535 Oakmont Blvd Ste 101 Fort Worth TX 76132-4237 | |
| (800) 972-2054 | |
| (214) 279-5032 |
| Full Name | Grace Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 7535 Oakmont Blvd Ste 101, Fort Worth, Texas |
| Authorized Official Name and Position | Cheryl Ann Rayl (DIRECTOR) |
| Authorized Official Contact | 8009720643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Counseling Center 4251 Fm 2181 Ste 230-517 Corinth TX 76210 Ph: (800) 972-0643 | Grace Counseling Center 7535 Oakmont Blvd Ste 101 Fort Worth TX 76132-4237 Ph: (800) 972-2054 |
| NPI Number | 1891044228 |
|---|---|
| Provider Enumeration Date | 08/30/2012 |
| Last Update Date | 09/10/2022 |
| Certification Date | 09/10/2022 |
| Medicare PECOS PAC ID | 2466776190 |
|---|---|
| Medicare Enrollment ID | O20150128001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891044228 | NPI | - | NPPES |
| Provider Name | Shekinah I Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225751787 PECOS PAC ID: 0749652089 Enrollment ID: I20230214001674 |
| Provider Name | David Gerald Simeone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407248818 PECOS PAC ID: 9830548825 Enrollment ID: I20231215002982 |
| Provider Name | Heather Elizabeth Cupp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780170340 PECOS PAC ID: 3274983473 Enrollment ID: I20240102000002 |
| Provider Name | Angela Latrice Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750732699 PECOS PAC ID: 0941571954 Enrollment ID: I20240102000843 |
| Provider Name | Kevin R. Bolt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326759648 PECOS PAC ID: 7416308820 Enrollment ID: I20240110002941 |
| Provider Name | Serra Ramey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932702545 PECOS PAC ID: 4183075435 Enrollment ID: I20240110004853 |
| Provider Name | Erica Leigh Ramage |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013186980 PECOS PAC ID: 1254783343 Enrollment ID: I20240112004006 |
| Provider Name | David Howard Laubach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134292865 PECOS PAC ID: 7315399276 Enrollment ID: I20240117001075 |
| Provider Name | Shelley Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154098754 PECOS PAC ID: 7012369283 Enrollment ID: I20240123005002 |
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