Graceway Counseling Services LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

GRACEWAY COUNSELING SERVICES LLC

Doing business as

Graceway Counseling Center

Practice address

744 4TH Ave Ste 2
Huntington, WV 25701-1541

Phone

(304) 691-0873

Fax

(304) 955-9057

NPI assigned

Jan 14, 2021

Last updated

Sep 5, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Matthew Maynard, MA, NCCNPI 1750970711

Title

Owner

Phone

(304) 691-0873

Specialties & licenses 4

Addresses

Other names 1

• Graceway Counseling Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Maynard, MA, NCC

  • Professional Counselor
  • Huntington, WV
  • NPI 1750970711
  Medicare reassignment Care Compare group NPD Authorized official
• Carolyn Collins, LPC

  • Mental Health Counselor
  • Huntington, WV
  • NPI 1902223829
  Medicare reassignment Care Compare group NPD
• Rebeka Ann Copley, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1376090050
  Medicare reassignment Care Compare group NPD
• Angela Carol Juniper, LPC

  • Professional Counselor
  • Huntington, WV
  • NPI 1750322632
  Medicare reassignment Care Compare group NPD
• Christina Kincaid

  • Professional Counselor
  • Huntington, WV
  • NPI 1205653151
  Medicare reassignment Care Compare group NPD
• Thomas Roy Lester II, L.P.C.

  • Professional Counselor
  • Huntington, WV
  • NPI 1962809293
  Medicare reassignment Care Compare group NPD
• Carly Marie Ball

  • Counselor
  • South Point, OH
  • NPI 1144966805

  WV

  Medicare reassignment Care Compare group NPD
• Sarah Baumgardner, LPC

  • Professional Counselor
  • Huntington, WV
  • NPI 1497472542
  NPD
• Morgan Duffy, MSW

  • Social Worker
  • Huntington, WV
  • NPI 1023905841
  NPD
• Julia Lilly

  • Professional Counselor
  • Huntington, WV
  • NPI 1578496527
  NPD
• Jacqueline Rollyson, LPC

  • Professional Counselor
  • Huntington, WV
  • NPI 1275292054
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1003405978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 4TH AVE STE 2",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011541",
            "telephone_number": "304-691-0873",
            "fax_number": "304-955-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 4TH AVE STE 2",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257011541",
            "telephone_number": "304-691-0873",
            "fax_number": "304-955-9057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Walnut Ln",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257049485",
            "country_code": "US",
            "telephone_number": "304-638-1551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACEWAY COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-691-0873",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graceway Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Graceway Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Gothard
• Mary Kathryn Gould, EDD, RDN, LD
• Balaji Govindaswami, MD
• David Gozal, M.D.
• Jill Grabosky, RN
• Vincent Anthony Graffeo, MD
• Jill Arian Gragg
• Angela D Graham, CNP
• Bethany Graham
• Jennifer Graham, LPC

• Family Nurse Practitioner in Huntington, WV
• Providers in Huntington, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.