Organization
GRACE PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HEWITT GRAESER LMHC (PRESIDENT)
(317) 413-6028
Entity
Organization
Contact information
Practice address
735 SHELBY ST UNIT 206, INDIANAPOLIS, IN 46203-1167
(317) 413-6028
(317) 245-2550
Mailing address
735 SHELBY ST UNIT 206, INDIANAPOLIS, IN 46203-1167
(317) 413-6028
(317) 254-2550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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