Individual
GRACE MURETTA PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCAS-A
Contact information
Practice address
436 E LONG AVE STE 1, GASTONIA, NC 28054-2543
(980) 888-7258
(704) 396-6356
Mailing address
123 MULLINAX DR, GROVER, NC 28073-9584
(704) 421-5464
(704) 396-6356
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-20091
NC
101YM0800X
Mental Health Counselor
11148
NC
101YP2500X
Professional Counselor
Primary
11148
NC
Other
Enumeration date
06/18/2014
Last updated
10/04/2021
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