Organization Active NPI

Grace Wellness Center LLC

  • Mental Health Counselor
  • Mesa, AZ
National Provider Identifier
1457995813
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GRACE WELLNESS CENTER LLC
Practice address
3707 E Southern Ave
Mesa, AZ 85206-2569
Phone
(702) 937-7789
NPI assigned
Oct 29, 2019
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Johna DeanNPI 1144678681
Title
Owner
Phone
(702) 937-7789

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Assisted Living Facility (Mental Illness) 3104A0625X
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

3707 E Southern Ave
Mesa, AZ 85206-2569

Mailing address

1024 W Owens Ave Ste B
Las Vegas, NV 89106-2520
Phone (702) 937-7789

Other practice location 1

159 W Broadway Ste 200
Salt Lake City, UT 84101-1923
Phone (702) 937-7789

Other practice location 2

1815 E Lake Mead Blvd
North Las Vegas, NV 89030-7187
Phone (725) 204-6732

National Provider Directory

National Provider Directory

Locations

3600 Cambridge St
Ste 200
Las Vegas, NV 89169

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1457995813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 W OWENS AVE STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062520",
            "telephone_number": "702-937-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062569",
            "telephone_number": "702-937-7789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 W Broadway Ste 200",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841011923",
            "country_code": "US",
            "telephone_number": "702-937-7789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 E Lake Mead Blvd",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890307187",
            "country_code": "US",
            "telephone_number": "725-204-6732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "JOHNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-937-7789"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.