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Organization
LED BY GRACE, LLC.
Active
Organization
LED BY GRACE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE CRAWFORD LCSW, LCAS (CEO)
(704) 629-8756
Entity
Organization
Contact information
Practice address
710 CHESWICK AVE, CONCORD, NC 28025-7079
(704) 629-8756
Mailing address
710 CHESWICK AVE, CONCORD, NC 28025-7079
(704) 629-8756
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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