Provider Demographics
NPI:1942002100
Name:A PLACE OF GRACE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:A PLACE OF GRACE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:GRACEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTARI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:702-848-5888
Mailing Address - Street 1:111 S GIBSON RD APT 3304
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2670
Mailing Address - Country:US
Mailing Address - Phone:845-820-7685
Mailing Address - Fax:
Practice Address - Street 1:8565 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2808
Practice Address - Country:US
Practice Address - Phone:702-848-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)