Organization
AMAZING GRACE COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NECOLE W. FRYAR MA, LPC (CEO)
(210) 883-6287
Entity
Organization
Contact information
Practice address
9830 APPELLATE WAY, CONVERSE, TX 78109-1985
(210) 883-6287
(210) 305-5750
Mailing address
9830 APPELLATE WAY, CONVERSE, TX 78109-1985
(210) 883-6287
(210) 305-5750
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
66851
TX
261QM0850X
Adult Mental Health Clinic/Center
Primary
66851
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3455909-01
—
TX
Enumeration date
11/18/2014
Last updated
12/01/2016
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