Individual provider Active NPI

Grace Catherine Mickle, LMFT

  • Marriage & Family Therapist
  • Brawley, CA
National Provider Identifier
1750932414
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
153519 Issued in CA
Practice address
507 Willard Ave
Brawley, CA 92227-3048
Phone
(619) 585-7686
NPI assigned
Sep 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717002396 VA
Marriage & Family Therapist 106H00000X 153519 CA Primary

Addresses

Primary practice location

507 Willard Ave
Brawley, CA 92227-3048

Mailing address

507 Willard Ave
Brawley, CA 92227-3048
Phone (619) 585-7686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
153519CAMDMarriage & Family Therapist
0717002396VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Selves Holistic Counseling and Therapeutic Services LLC Marriage & Family Therapist CurrentSince Mar 11, 2025 Accepting new patients
Community Research Foundation PastSince Mar 1, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1750932414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 WILLARD AVE",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922273048",
            "telephone_number": "619-585-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 WILLARD AVE",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922273048",
            "telephone_number": "619-585-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "GRACE",
        "middle_name": "CATHERINE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717002396",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "153519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.