Active NPI
Mary B Grimmer, LCSW
- Social Worker
- Orlando, FL
National Provider Identifier
1083786370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 601 W Michigan St
Orlando, FL 32805-6203 - Phone
- (407) 317-7430
- Fax
- (407) 540-1925
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 8196 | FL | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
601 W Michigan St
Orlando, FL 32805-6203
Mailing address
3873 Old Dunn Rd
Apopka, FL 32712-4788
Phone (407) 814-9433
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7680899 | Medicaid | FL | |
| 8117527 00 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 8196 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334448000000",
"number": "1083786370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3873 OLD DUNN RD",
"city": "APOPKA",
"state": "FL",
"postal_code": "327124788",
"telephone_number": "407-814-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W MICHIGAN ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328056203",
"telephone_number": "407-317-7430",
"fax_number": "407-540-1925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMMER",
"first_name": "MARY",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2012-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 8196",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7680899",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8117527 00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.