Individual provider Active NPI

Mallory Anne Grimste, LCSW

  • Social Worker
  • Branford, CT
National Provider Identifier
1841591609
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
250 W Main St Ste 203
Branford, CT 06405-4032
Phone
(203) 228-8971
Fax
(203) 429-8628
NPI assigned
Nov 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

250 W Main St Ste 203
Branford, CT 06405-4032

Mailing address

250 W Main St Ste 203
Branford, CT 06405-4032
Phone (203) 228-8971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 7, 2023 through Dec 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
091533NYMDAddiction (Substance Use Disorder) Counselor
008407CTMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mallory Grimste LLC CurrentSince Dec 14, 2025 Accepting new patients

Locations

250 W Main St
Ste 203
Branford, CT 06405
Phone (203) 228-8971

30 Hazel Ter
Ste 12
Woodbridge, CT 06525
Phone (203) 228-8971

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1841591609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST STE 203",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054032",
            "telephone_number": "203-228-8971",
            "fax_number": "203-429-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST STE 203",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054032",
            "telephone_number": "203-228-8971",
            "fax_number": "203-429-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSTE",
        "first_name": "MALLORY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.