ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC
NPI 1053275206
Peer Specialist in Charlotte, NC

Q: What is Abundantly Graced Community Supportive Services Inc's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Active since December 11, 2025

5736 N TRYON ST STE 125A, CHARLOTTE, NC 28213(704) 713-5652 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 11, 2026, Jan 23, 2026, Dec 11, 2025 (3 updates tracked since 2025).

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About Abundantly Graced Community Supportive Services Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC (NPI 1053275206) is a healthcare organization registered as a peer specialist in Charlotte, North Carolina and active in the NPI registry since December 2025. The organization lists Lastarra Shawnta Mcdonald, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053275206

Entity TypeOrganization

Primary Taxonomy175T00000X

Legal Business NameABUNDANTLY GRACED COMMUNITY SUPPORTIVE SERVICES INC

Location Address5736 N TRYON ST STE 125ACharlotte, NC 28213-6886

Mailing Address5736 N Tryon St Ste 125aCharlotte, NC 28213-6886 · (704) 713-5652

Phone(704) 713-5652

Organization SubpartNo

Authorized OfficialLastarra Shawnta McdonaldCeo · (704) 819-1965

Enumeration DateDecember 11, 2025

Last NPPES UpdateMarch 11, 20263 updates tracked since enumeration

NPPES CertifiedMarch 11, 2026

✔ NPI 1053275206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedMealsTaxonomy 174200000X

Also ListedCase ManagementTaxonomy 251B00000X

Also ListedHome HealthTaxonomy 251E00000X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedIn Home Supportive CareTaxonomy 253Z00000X

Also ListedAdult CompanionTaxonomy 372600000X

Also ListedRespite Care · Respite Care, Intellectual and/or Developmental DisabilitiesTaxonomy 385HR2060X

5736 N TRYON ST STE 125A, Charlotte, NC 28213

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Abundantly Graced Community Supportive Services Inc's NPI number?

The NPI number for Abundantly Graced Community Supportive Services Inc is 1053275206. It was assigned to this organization in the NPPES registry on December 11, 2025.

Where is Abundantly Graced Community Supportive Services Inc located?

Abundantly Graced Community Supportive Services Inc is located at 5736 N Tryon St Ste 125A, Charlotte, NC 28213. The listed phone number is (704) 713-5652.

What is Abundantly Graced Community Supportive Services Inc's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Abundantly Graced Community Supportive Services Inc was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.