GRACE THERAPEUTIC SERVICES LLC (NPI# 1174088520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174088520 |
| Entity Type | Organization |
| Organization Name | GRACE THERAPEUTIC SERVICES LLC |
| Practice Address |
1111 Street Rd Ste 101 Southampton PA 18966-4250 |
| Mailing Address |
1922 Preston Ave Willow Grove PA 19090-3027 |
| Practice Telephone | 2157409875 |
| Mailing Telephone | 2157409875 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |
| Authorized Official Name | JOSEPH R DONNELLY (CEO) |
| Authorized Official Telephone | 2157409875 |
| Authorized Official Credential | MS, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
1111 STREET RD STE 101 |
| City | SOUTHAMPTON |
| State | PA |
| Zip Code | 18966-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730176025 | Nancy Acker | Psychologist | 1111 Street Rd Ste 101, Southampton, PA 18966-4250 | 2005-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033758636 | Nancy Rubin | Speech-Language Pathologist | Nancy Rubin, 32 Brook Drive, Southampton, PA 18966 | 2019-12-30 |
| 1265970669 | Dominic Bogucki | Specialist/Technologist | 75 Meadowfield Dr, Southampton, PA 18966 | 2017-02-06 |
| 1518404359 | Amanda Phillips | Social Worker | 504 Lakeside Office Park, Suite 504, Southampton, PA 18966 | 2017-01-31 |
| 1386988830 | Sara Beth Bergman | Occupational Therapy Assistant | 1354 Hi View Drive, Southampton, PA 18966 | 2012-11-22 |
| 1326325523 | Annie Varughese | Pharmacist | 139 Lark Dr, Holland, PA 18966 | 2011-11-16 |
| 1912284993 | Christine Renee Nichols | Social Worker | 1030 Second Street Pike, Southampton, PA 18966 | 2011-11-04 |
| 1407134125 | Apex Smiles LLC | Dentist | 771 2nd Street Pike, Southampton, PA 18966 | 2011-07-29 |
| 1790092708 | The Comprehensive Learning Center, Inc. | Community/Behavioral Health | 150 James Way, Southampton, PA 18966 | 2010-09-13 |
| 1861713786 | Austin Patrick Daly | Dentist | 404 Lakeside Park, Southampton, PA 18966 | 2010-06-15 |
| 1164660015 | Andrew J Sohl | Podiatrist | 86 Buck Rd Ste 2, Southampton, PA 18966 | 2009-01-30 |
| Find all providers in zip 18966 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548783186 | Gina Girono | Counselor | 928 Jaymor Rd Ste B150, Southampton, PA 18966-3853 | 2017-07-25 |
| 1487796413 | Kyle Francis Walsh | Counselor | 504 Lakeside Drive, Southampton, PA 18966 | 2007-02-13 |
| 1669983193 | Alina Tsirelson | Counselor | 201 Lakeside Park, Southampton, PA 18966-4049 | 2017-10-24 |
| 1942723960 | Regan Lee-kin | Counselor | 928 Jaymor Rd Ste B-150, Southampton, PA 18966-3853 | 2017-07-21 |
| 1710364567 | Victoria Schultheis | Counselor | 928 Jaymor Rd, Southampton, PA 18966-3826 | 2015-04-30 |
| 1538506449 | Brent Phillip Brendle | Counselor | 63 Main St, Southampton, NJ 08088-8869 | 2013-05-31 |
| 1992047542 | Cristina Lyn Smolenak | Counselor | 504 Lakeside Park, Southampton, PA 18966-4078 | 2013-03-21 |
| 1477829844 | Growth Opportunity Center | Counselor | 928 Jaymor Rd, B150, Southampton, PA 18966 | 2012-03-29 |
| 1629355128 | Michael Lee Zanders | Counselor | 1030 Second Street Pike, Southampton, PA 18966-3955 | 2011-11-11 |
| 1104141696 | Emotional Harmony, LLC | Counselor | 501 Street Rd, Floor 2, Southampton, PA 18966-3796 | 2010-03-29 |
| Find all providers in SOUTHAMPTON | ||||
| City | SOUTHAMPTON |
| Zip Code | 18966 |
Please comment or provide details below to improve the information on GRACE THERAPEUTIC SERVICES LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.