Kimberly Grim, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.2207792 Issued in OH

Practice address

502 McCarty LN Ste 1
Jackson, OH 45640-7025

Phone

(740) 577-9003

Fax

(740) 577-9184

NPI assigned

Mar 13, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Jones Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1174026405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MCCARTY LN STE 1",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456407025",
            "telephone_number": "740-577-9003",
            "fax_number": "740-577-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MCCARTY LN STE 1",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456407025",
            "telephone_number": "740-577-9003",
            "fax_number": "740-577-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "KIMBERLY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2207792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864002",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JONES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Craig Roger Green, OD
• Cody Allen Greenberg
• Rebekah S Greenlee, LSW
• Kimberly N. Gregg-Cornell, PT
• Hayden O Griffith
• David B Grimm, CRNA
• Amy Louise Grube, FNP
• Allison Gutierrez, LPCC
• Kyle Hagen
• Chris Hager

• Clinical Social Worker in Jackson, OH
• Providers in Jackson, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.