NPIMap

Organization Active NPI

Grace Behavioral Health & Wellness, LLC

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1841734878
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GRACE BEHAVIORAL HEALTH & WELLNESS, LLC
Practice address
145 Church St NE Ste 105
Marietta, GA 30060-1620
Phone
(404) 618-6955
NPI assigned
Dec 9, 2016
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Donna-Jean Owens, LCSWNPI 1912267782
Title
Owner
Phone
(404) 618-6955

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X CSW003676 GA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

145 Church St NE Ste 105
Marietta, GA 30060-1620

Mailing address

145 Church St NE Ste 105
Marietta, GA 30060-1620
Phone (404) 618-6955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230707000396 GA Part B Supplier - Clinic/Group Practice 0547629602 Receives reassigned benefits from 3 practitioners
Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

145 Church St NE
Ste 285
Marietta, GA 30060

Practitioners & affiliated clinicians

Practitioners 5

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": "1481241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1841734878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CHURCH ST NE STE 105",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601620",
            "telephone_number": "404-618-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CHURCH ST NE STE 105",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601620",
            "telephone_number": "404-618-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE BEHAVIORAL HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-09",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "DONNA-JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-618-6955",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "CSW003676",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.