LAUREL GRACE MENTAL HEALTH AND WELLNESS
NPI 1154024966
Nurse Practitioner - Psychiatric/Mental Health in Thonotosassa, FL
About Laurel Grace Mental Health And Wellness NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAUREL GRACE MENTAL HEALTH AND WELLNESS (NPI 1154024966) is a healthcare organization registered as a psychiatric/mental health in Thonotosassa, Florida and active in the NPI registry since March 2023. The organization lists Lalencia L Matthews, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Laurel Grace Mental Health And Wellness is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Laurel Grace Mental Health And Wellness, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Laurel Grace Mental Health And Wellness's NPI number?
The NPI number for Laurel Grace Mental Health And Wellness is 1154024966. It was assigned to this organization in the NPPES registry on March 22, 2023.
Where is Laurel Grace Mental Health And Wellness located?
Laurel Grace Mental Health And Wellness is located at 9614 Troncais Cir, Thonotosassa, FL 33592. The listed phone number is (612) 388-4661.
What is Laurel Grace Mental Health And Wellness's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Laurel Grace Mental Health And Wellness enrolled in Medicare?
Yes. Laurel Grace Mental Health And Wellness is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Laurel Grace Mental Health And Wellness?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Laurel Grace Mental Health And Wellness. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Laurel Grace Mental Health And Wellness was last updated on March 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Laurel Grace Mental Health And Wellness · NPI 1154024966
Psychiatric/Mental Health organization in Thonotosassa, Florida. Organization record, active in the CMS NPPES registry since March 22, 2023.
## Identity
- **NPI:** 1154024966 (Entity type: Organization)
- **Enumerated:** March 22, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Lalencia Matthews, CEO
## Practice location
- **Address:** 9614 TRONCAIS CIR, Thonotosassa, FL 33592-3412
- **Phone:** (612) 388-4661
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 22, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1154024966) · Data from the CMS NPPES public registry.