NPIMap

Organization Active NPI

Grace Christian Counseling Center

  • Marriage & Family Therapist
  • Vicksburg, MS
National Provider Identifier
1447295654
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
C5390 Issued in MS
Legal business name
GRACE CHRISTIAN COUNSELING CENTER
Practice address
1414 Cherry St
Vicksburg, MS 39180-3218
Phone
(601) 636-5703
Fax
(601) 636-5739
NPI assigned
Jun 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Walter Lee Frazier, LPC,MCP,NCCNPI 1033168299
Title
Executive Director
Phone
(601) 636-5703

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 779 MS
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 1046 MS
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X C5390 MS
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X C5390 MS Primary

Addresses

Primary practice location

1414 Cherry St
Vicksburg, MS 39180-3218

Mailing address

1414 Cherry St
Vicksburg, MS 39180-3218
Phone (601) 636-5703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240130002733 MS Part B Supplier - Clinic/Group Practice 0749285070 Receives reassigned benefits from 8 practitioners
Practice locations: Vicksburg, MS

National Provider Directory

National Provider Directory

Locations

210 E Peace St
Canton, MS 39046
Phone (601) 363-5703

1414 Cherry St
Vicksburg, MS 39180
Phone (601) 636-5703

629 Cherry St
Vicksburg, MS 39183
Phone (601) 619-9172

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1447295654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CHERRY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803218",
            "telephone_number": "601-636-5703",
            "fax_number": "601-636-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CHERRY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803218",
            "telephone_number": "601-636-5703",
            "fax_number": "601-636-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CHRISTIAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-636-5703",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC,MCP,NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "779",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1046",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MS",
            "license": "C5390",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "C5390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.