Jacqueline Marie Grim, LGSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

51 Southland Dr
Fairmont, WV 26554-0129

Phone

(304) 290-4615

NPI assigned

Apr 14, 2025

Last updated

Apr 14, 2025By the provider in NPPES

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

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1760277412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SOUTHLAND DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SOUTHLAND DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540129",
            "telephone_number": "304-290-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skyler Grogg
• Amy Gruber, PA-C
• Guardian Elder Care at Fairmont LLC (Fairmont Healthcare and Rehabilitation Center)
• Doren Gump

• Clinical Social Worker in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.