Thomas Donald Grinnell Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

079421-1 Issued in NY

Practice address

625 Delaware Ave
Suite 204
Buffalo, NY 14202-1009

Phone

(716) 882-3151

Fax

(716) 886-4002

NPI assigned

Sep 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mid Erie Mental Health Services Inc

  • Counselor
  • Cheektowaga, NY
  • NPI 1225095201
  Medicare reassignment NPD

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1578711685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 DELAWARE AVE",
            "address_2": "SUITE 300",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142022016",
            "telephone_number": "716-842-0440",
            "fax_number": "716-842-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 DELAWARE AVE",
            "address_2": "SUITE 204",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021009",
            "telephone_number": "716-882-3151",
            "fax_number": "716-886-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINNELL",
        "first_name": "THOMAS",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079421-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Grimaldi, NURSE PRACTIONER
• Eric Grimaldi
• Samantha Jo Grimaldi, MS, RD, CDCES, CDN
• Jennifer Elizabeth Grimmer, FNP
• Victoria Lynn Griner, PA-C
• John Batista Grippi, M.D.
• Kim S Griswold, MD
• Karolyn P Groff
• Kerry Kathleen Grohman, PH.D.
• Lisa Gromlovits

• Clinical Social Worker in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.