| Grit And Grace Counseling Llc | |
|
312 E Dupont Rd Ste 101 Fort Wayne IN 46825-8000 | |
| (260) 227-5900 | |
| Not Available |
| Full Name | Grit And Grace Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 312 E Dupont Rd Ste 101, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kelsey Tiernon (OWNER/FOUNDER) |
| Authorized Official Contact | 2602275900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grit And Grace Counseling Llc 1817 Beineke Rd Fort Wayne IN 46808-1627 Ph: () - | Grit And Grace Counseling Llc 312 E Dupont Rd Ste 101 Fort Wayne IN 46825-8000 Ph: (260) 227-5900 |
| NPI Number | 1871244657 |
|---|---|
| Provider Enumeration Date | 01/13/2022 |
| Last Update Date | 01/26/2022 |
| Certification Date | 01/26/2022 |
| Medicare PECOS PAC ID | 3375982861 |
|---|---|
| Medicare Enrollment ID | O20240417000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871244657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelsey E. Tiernon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952828014 PECOS PAC ID: 6002255593 Enrollment ID: I20240417000348 |
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