Individual provider · Type 1 NPI
Grace Park, LCPC
Professional Counselor · Portland, ME
NPI number
1710647813
Active
Practice location
104 Brackett St
Portland, ME 04102-3824
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | CC7280 (ME) |
Professional Counselor: Definition to come...
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About NPI 1710647813
Grace Park, LCPC's National Provider Identifier is 1710647813, issued on Dec 30, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Portland, ME. The record was last updated on Nov 4, 2025.