# ESSENTIAL GRACE THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114526548
- **Authorized official:** MRS. JODI ANN SMITH MS, LMFT (OWNER)
- **Authorized official phone:** (763) 291-0468

## Contact information

- **Practice address:** 12390 SHERBURNE AVE STE 210, BECKER, MN 55308-9147
- **Practice address phone:** (763) 291-0468
- **Mailing address:** 24910 184TH ST NW, BIG LAKE, MN 55309-9788
- **Mailing address phone:** (763) 291-0468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/16/2020
- **Last updated:** 11/04/2020