Organization
GRACEWAY SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI RAE BETHEA-BYRD LPC , LCAS-A (MENTAL HEALTH COUNSELOR)
(910) 874-0769
Entity
Organization
Contact information
Practice address
12514 NC 242 HWY S, BLADENBORO, NC 28320-6026
(910) 874-0769
Mailing address
12514 NC 242 HWY S, BLADENBORO, NC 28320-6026
(910) 874-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13016236658
NPPES
NC
05
—
PC1568
—
SC
Enumeration date
06/26/2017
Last updated
07/21/2022
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