Marcellan Louise Grimsley, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2304804 Issued in OH

Practice address

340 S Broadway St
Akron, OH 44308-1529

Phone

(330) 253-3100

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portage Path Community Mental Health CenterGroup PAC ID 5597663344, 46 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Portage Path Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
  • NPI 1225087802
  Medicare reassignment Care Compare group NPD
• Portage Path Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1114492147
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1649759937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-263-0380",
            "fax_number": "330-263-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "MARCELLAN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2304804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyreia Louise Grimes, PRS
• Melissa S Grimm, RN, CNS, BC
• Wyatt Grimm, D.O.
• Jacob Grimmer, DO
• Mary Elizabeth Nelson Grimmett, NURSE PRACTITIONER
• Kasey Lee Grinstead, DO
• Sarah Jane Grinstead, DO
• Bryce Gregory Grisez, RN
• Suzanne Grisez
• Monique Grissom

• Professional Counselor in Akron, OH
• Providers in Akron, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.