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Organization
SPACE FOR GRACE, LLC
Active
Organization
SPACE FOR GRACE, LLC
Active
Other names
Space for Grace, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE P LEWIS LCPC, LCADC, NBCC (OWNER)
(443) 889-2569
Entity
Organization
Contact information
Practice address
10208 CASCADE RUN CT, OWINGS MILLS, MD 21117-5836
(443) 985-7294
Mailing address
10208 CASCADE RUN CT, OWINGS MILLS, MD 21117-5836
(443) 985-7294
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
NULL
101YP1600X
Pastoral Counselor
—
—
Other
Enumeration date
10/29/2020
Last updated
11/11/2020
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