Grace in Healings PLLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

GRACE IN HEALINGS PLLC

Practice address

5301 Alpha Rd Ste 80-3
Dallas, TX 75240-4355

Phone

(682) 215-1691

Fax

(682) 267-4840

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Prajnawati WibowoNPI 1760959696

Title

Ceo

Phone

(682) 215-1691

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Prajnawati Wibowo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1760959696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1699557694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 ALPHA RD STE 80-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404355",
            "telephone_number": "682-215-1691",
            "fax_number": "682-267-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 ALPHA RD STE 80-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404355",
            "telephone_number": "682-215-1691",
            "fax_number": "682-267-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE IN HEALINGS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "WIBOWO",
        "authorized_official_first_name": "PRAJNAWATI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "682-215-1691"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Compassion Healthcare Staffing LLC
• Grace Compassion Hospice Care LLC
• Grace Compassion Transportation Services Inc
• Grace Eye Clinic PA
• Grace Focus Care Services, LLC
• Grace Outreach
• Grace Place Collin LLC
• Grace Place Counseling, PLLC
• Grace Presbyterian Ministries, Inc.
• Grace Southern Medical Clinic, PLLC

• Psychiatric/Mental Health Registered Nurse in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.