Individual provider Active NPI

Victoria Grimaldo, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Howard, OH
National Provider Identifier
1528500097
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.161935 Issued in OH
Practice address
59 Penlawn CT
Howard, OH 43028-9536
Phone
(740) 326-1809
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.161935 OH Primary

Addresses

Primary practice location

59 Penlawn CT
Howard, OH 43028-9536

Mailing address

59 Penlawn CT
Howard, OH 43028-9536
Phone (740) 326-1809

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

LicenseStateTypeSpecialty
CDCA.161935OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1528500097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 PENLAWN CT",
            "city": "HOWARD",
            "state": "OH",
            "postal_code": "430289536",
            "telephone_number": "740-326-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PENLAWN CT",
            "city": "HOWARD",
            "state": "OH",
            "postal_code": "430289536",
            "telephone_number": "740-326-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDO",
        "first_name": "VICTORIA",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.161935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.