Active NPI
Nicole Elena Grimm, L.P.C.
- Counselor
- Clemson, SC
National Provider Identifier
1396070389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6599
- Practice address
- 100 McCollum St Ste 2
Clemson, SC 29631-1532 - Phone
- (864) 710-0391
- NPI assigned
- Oct 8, 2009
- Last updated
- Nov 14, 2017
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6599 | SC | Primary |
Addresses
Primary practice location
100 McCollum St Ste 2
Clemson, SC 29631-1532
Mailing address
100 McCollum St Ste 2
Clemson, SC 29631-1532
Phone (864) 710-0391
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 |
|---|---|---|---|
| 6599 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510617600000",
"number": "1396070389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MCCOLLUM ST STE 2",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296311532",
"telephone_number": "864-710-0391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MCCOLLUM ST STE 2",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296311532",
"telephone_number": "864-710-0391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "NICOLE",
"middle_name": "ELENA",
"name_prefix": "Mrs.",
"credential": "L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-08",
"last_updated": "2017-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "SC",
"license": "6599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clemson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.