NPIMap

Organization Active NPI

Space for Grace, LLC

  • Mental Health Counselor
  • Owings Mills, MD
National Provider Identifier
1396345351
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SPACE FOR GRACE, LLC
Practice address
10208 Cascade Run CT
Owings Mills, MD 21117-5836
Phone
(443) 985-7294
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Authorized official

Name
Renee P Lewis, LCPC, LCADC, NBCCNPI 1720229701
Title
Owner
Phone
(443) 889-2569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X

Addresses

Primary practice location

10208 Cascade Run CT
Owings Mills, MD 21117-5836

Mailing address

10208 Cascade Run CT
Owings Mills, MD 21117-5836
Phone (443) 985-7294

Other names 1

  • Space for Grace, LLC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL WWW.Space4gracellc.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1396345351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 CASCADE RUN CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175836",
            "telephone_number": "443-985-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 CASCADE RUN CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175836",
            "telephone_number": "443-985-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE FOR GRACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-889-2569",
        "authorized_official_credential": "LCPC, LCADC, NBCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.Space4gracellc.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10208 Cascade Run Ct",
            "city": "Owings Mills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211175836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Space for Grace, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.