Brenda Ann Grimes, LISWS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

I.0009117 Issued in OH

Practice address

4200 Park Avenue
Ashtabula, OH 44004

Phone

(440) 992-8552

Fax

(440) 992-6631

NPI assigned

Oct 15, 2010

Last updated

Oct 15, 2010By 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

Other names 1

• Brenda Ann Martin Former name

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

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Healthcare Partners of Central Ohio IncGroup PAC ID 3971499385, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Healthcare Partners of Central Ohio Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newark, OH
  • NPI 1063479079
  Medicare reassignment Care Compare group NPD
• The North Coast Center

  • Community/Behavioral Health Agency
  • Ashtabula, OH
  • NPI 1043340946
  NPD (past)

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1912217670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 PARK AVENUE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "44004",
            "telephone_number": "440-992-8552",
            "fax_number": "440-992-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PARK AVENUE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "44004",
            "telephone_number": "440-992-8552",
            "fax_number": "440-992-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "credential": "LISWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.0009117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "MARTIN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robin Lee Green
• Noah Greenawalt
• Greenelight Workforce, LLC
• Tracy L Griffin, STNA
• Susan Marie Griggs
• Angel Gross
• Jennifer Guerrero
• Bruce Philip Guido, M.D.
• Lashawna Guijosa
• Christina Gulley, SCHOOL PSYCHOLOGIST

• Mental Health Counselor in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.