Michelle Grim, M.ED., SP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

SP.00638 Issued in OH

Practice address

539 Windsor Park Dr
Centerville, OH 45459-4112

Phone

(937) 409-6156

NPI assigned

Aug 5, 2016

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1750835922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 WINDSOR PARK DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 WINDSOR PARK DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594112",
            "telephone_number": "937-409-6156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 S Ludlow St",
            "address_2": "Psychological Services",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454021812",
            "country_code": "US",
            "telephone_number": "937-542-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIM",
        "first_name": "MICHELLE",
        "credential": "M.ED., SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "SP.00638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard L Greeno Jr., MD
• Casey Gries
• Alexis Griffin
• Lorenda R Griffin, MSW, LISW
• Nicole Lynn Griffith
• Jennifer Grimes
• Jeremy Michael Groll, MD
• Robert T Grossmann, MD
• Steven Michael Grout, O.D.
• Andrew Scott Gruner, PHARM D.

• Psychologist in Centerville, OH
• Providers in Centerville, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.