Individual
GRACE CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW CDCA
Contact information
Practice address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
S.1802996
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
03/03/2025
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