Provider Demographics
NPI:1902423668
Name:GRACIOUS WORDS COUNSELING, LLC
Entity Type:Organization
Organization Name:GRACIOUS WORDS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-564-0513
Mailing Address - Street 1:465 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-4860
Mailing Address - Country:US
Mailing Address - Phone:337-540-2190
Mailing Address - Fax:
Practice Address - Street 1:465 DERBY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-4860
Practice Address - Country:US
Practice Address - Phone:337-564-0513
Practice Address - Fax:337-564-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)