NPIMap

Organization Active NPI

Grace N Mercy Support Services LLC

  • Peer Specialist
  • Louisville, KY
National Provider Identifier
1790387074
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
GRACE N MERCY SUPPORT SERVICES LLC
Practice address
4206 Southern Pkwy # 1a
Louisville, KY 40214-1650
Phone
(502) 365-2216
Fax
(502) 749-0055
NPI assigned
Nov 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Authorized official

Name
Mrs. April Roann RobertsonNPI 1326676578
Title
Owner/ Peer Support
Phone
(270) 300-6819

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
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

4206 Southern Pkwy # 1a
Louisville, KY 40214-1650

Mailing address

4206 Southern Pkwy # 1a
Louisville, KY 40214-1650
Phone (502) 365-2216

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1790387074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 SOUTHERN PKWY # 1A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141650",
            "telephone_number": "502-365-2216",
            "fax_number": "502-749-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 SOUTHERN PKWY # 1A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141650",
            "telephone_number": "502-365-2216",
            "fax_number": "502-749-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE N MERCY SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "ROANN",
        "authorized_official_title_or_position": "OWNER/ PEER SUPPORT",
        "authorized_official_telephone_number": "270-300-6819",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.