Provider Demographics
NPI:1376423764
Name:MERCY & GRACE COUNSELING PLLC
Entity type:Organization
Organization Name:MERCY & GRACE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-A, LCAS-A, CPSS
Authorized Official - Phone:336-470-4475
Mailing Address - Street 1:4055 HEATHER VIEW LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-4517
Mailing Address - Country:US
Mailing Address - Phone:336-470-4475
Mailing Address - Fax:
Practice Address - Street 1:4055 HEATHER VIEW LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-4517
Practice Address - Country:US
Practice Address - Phone:336-470-4475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty