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Organization
GRACE COUNSELING SERVICES
Active
Organization
GRACE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PENNY MAIN-BENNETT LADC (OWNER & DIRECTOR)
(763) 413-8838
Entity
Organization
Contact information
Practice address
21471 ULYSSES ST. NE, EAST BETHEL, MN 55011
(763) 413-8838
(763) 413-8878
Mailing address
21471 ULYSSES ST. NE, EAST BETHEL, MN 55011
(763) 413-8838
(763) 413-8878
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640067100
—
MN
Enumeration date
07/24/2023
Last updated
07/24/2023
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