Grace Valley Clinical Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

GRACE VALLEY CLINICAL SERVICES

Practice address

27 Holmes Dr
Windsor, CT 06095-3969

Phone

(806) 905-4776

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Krystal KellyNPI 1821753658

Title

Ceo

Phone

(860) 905-4776

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Krystal Kelly, LPC

  • Professional Counselor
  • Bloomfield, CT
  • NPI 1821753658
  NPD Authorized official
• Christopher Balbo, LPC-A

  • Professional Counselor
  • Bloomfield, CT
  • NPI 1932799137
  NPD (past)

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1841926045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060950186",
            "telephone_number": "860-905-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 HOLMES DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953969",
            "telephone_number": "806-905-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE VALLEY CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-905-4776"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marva Gooden, APRN-FNP
• Daniella Ashley Gordon, APRN
• Kimberly T Gordon, LPC
• Lonnette Gordon
• Krithi Goud
• Robert M Graff
• Grant Consult LLC
• Destiny Grant
• Emma Rose Grant
• Lucretia Grant, HOME CARE AGENCY

• Professional Counselor in Windsor, CT
• Providers in Windsor, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.