Michael Nolan Grimes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25272 Issued in CA

Practice address

555 Palm Ave Apt 107
Millbrae, CA 94030-1846

Phone

(415) 517-5372

NPI assigned

Jan 8, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1720595168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PALM AVE APT 107",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301846",
            "telephone_number": "415-517-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PALM AVE APT 107",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301846",
            "telephone_number": "415-517-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MICHAEL",
        "middle_name": "NOLAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Francesca Chavez Flores, PHARMD
• Jonathan Fong
• Melissa Ann Frederick, M.D.
• Giselle Galang, PHARM.D.
• Jeffrey Paul Gressard Sr., D.D.S.
• Amina Habib, MS. MFTI
• Becky Han
• Katrina Hary, RDHAP
• Hearts @ Millwood Rcfe, Inc.
• Jonathan Hee

• All providers in Millbrae, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.