Grace Healing Wellness Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GRACE HEALING WELLNESS CENTER

Practice address

8527 Rhuddlan Rd
Nottingham, MD 21236-2623

Phone

(443) 377-4672

NPI assigned

Apr 17, 2025

Last updated

Apr 17, 2025By 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

Raphael GikonyoNPI 1205458536

Title

President

Phone

(443) 377-4672

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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.

• Raphael Gikonyo, PHMNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Timonium, MD
  • NPI 1205458536
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1023804861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8527 RHUDDLAN RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212362623",
            "telephone_number": "443-377-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8527 RHUDDLAN RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212362623",
            "telephone_number": "443-377-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALING WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "GIKONYO",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-377-4672"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeann Goodson, CRNP-PMH
• Bria Michele Goodwin, LCSW-C
• Marcia A. Gordon, D.D.S.
• Niaya Gordon
• Elizabeth Kathlene Gousha, LMT
• Gracia Services LL
• Cornelius Green
• Kimberly Green, CEO, DO,
• Lauren Greenberg, LCPC
• Frances Dolores Lori Greenfeld, ATRBC; LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.