Maryam Mardanbigi Grimwood, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1804043 Issued in AR

Practice address

112 W Center St
Fayetteville, AR 72701-6073

Phone

(479) 316-7770

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1437190360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 E POLK DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034991",
            "telephone_number": "479-601-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W CENTER ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016073",
            "telephone_number": "479-316-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4960 Springhouse Drive",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "72762",
            "country_code": "US",
            "telephone_number": "479-695-1240",
            "fax_number": "479-750-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMWOOD",
        "first_name": "MARYAM",
        "middle_name": "MARDANBIGI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1804043",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1109095",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele L Griffin, NP-C
• Paul Griffin
• Ann Marie Grigg, M. S., CCC-SLP
• Ashley Grigsby, LPC
• Zane Calvin Grimes, PA
• Amanda Grob-Fitzgibbon, PT
• Walton W Grote, M.D.
• Grounded Within Chiropractic PLLC
• Megan Grove, PA-C
• Alan Dale Grover, O.D.

• Mental Health Counselor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.