Active NPI
Crystal Grimsley
- Professional Counselor
- Saint Peters, MO
National Provider Identifier
1265909428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2018033195
- Practice address
- 255 Spencer Rd Ste 101
Saint Peters, MO 63376-2574 - Phone
- (636) 477-6111
- NPI assigned
- Oct 25, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2018033195 | MO | Primary |
Addresses
Primary practice location
255 Spencer Rd Ste 101
Saint Peters, MO 63376-2574
Mailing address
255 Spencer Rd Ste 101
Saint Peters, MO 63376-2574
Phone (636) 477-6111
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 |
|---|---|---|---|
| 2018033195 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540425600000",
"number": "1265909428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 SPENCER RD STE 101",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633762574",
"telephone_number": "636-477-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 SPENCER RD STE 101",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633762574",
"telephone_number": "636-477-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMSLEY",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-25",
"last_updated": "2018-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2018033195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.