Grace Therapy, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4921 Issued in OK

Legal business name

GRACE THERAPY, INC.

Practice address

4870 S Lewis Ave
Suite 190
Tulsa, OK 74105-5151

Phone

(918) 869-5544

NPI assigned

Feb 1, 2016

Organization subpart

No

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

Authorized official

Name

Mylinda Renee Fanj, MS, LPC

Title

Mental Health Professional

Phone

(918) 869-5544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1639537970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 S LEWIS AVE",
            "address_2": "SUITE 190",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741055151",
            "telephone_number": "918-869-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 S LEWIS AVE",
            "address_2": "SUITE 190",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741055151",
            "telephone_number": "918-869-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "FANJ",
        "authorized_official_first_name": "MYLINDA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "918-869-5544",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "4921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eva Marie Grace
• Joyce L Grace
• Gracewell Homecare LLC
• Gracewood Health & Rehab LLC
• Gracewood Health SNF Operations LLC

• Community/Behavioral Health Agency in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.