Individual provider Active NPI

Grimarie Fernandez, MS, LMHC, MCAP

  • Mental Health Counselor
  • Kissimmee, FL
National Provider Identifier
1316495815
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH20482 Issued in FL
Practice address
600 N Thacker Ave Ste D31
Kissimmee, FL 34741-4808
Phone
(321) 732-2315
Fax
(321) 222-6228
NPI assigned
Sep 14, 2016
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X MH20482 FL Primary

Addresses

Primary practice location

600 N Thacker Ave Ste D31
Kissimmee, FL 34741-4808

Mailing address

600 N Thacker Ave Ste D31
Kissimmee, FL 34741-4808
Phone (321) 732-2315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1316495815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N THACKER AVE STE D31",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414808",
            "telephone_number": "321-732-2315",
            "fax_number": "321-222-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N THACKER AVE STE D31",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414808",
            "telephone_number": "321-732-2315",
            "fax_number": "321-222-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "GRIMARIE",
        "credential": "MS, LMHC, MCAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.