# GRACE OUT LOUD THERAPY SERVICES, LLC

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

## Provider details

- **NPI number:** 1417658295
- **Authorized official:** ANA-ALICIA FARRAR BROWN LICSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (336) 926-7476

## Contact information

- **Practice address:** 2150 SILVERSMITH CT, WOODBRIDGE, VA 22191-4123
- **Practice address phone:** (571) 412-1006
- **Mailing address:** 2150 SILVERSMITH CT, WOODBRIDGE, VA 22191-4123
- **Mailing address phone:** (571) 412-1006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/17/2023
- **Last updated:** 03/17/2023