Individual provider Active NPI

Elizabeth Jodi Grimaldi, LLMFT, MDIV

  • Marriage & Family Therapist
  • Grand Rapids, MI
National Provider Identifier
1932734357
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101007262 Issued in MI
Practice address
233 Fulton St E Ste 28
Grand Rapids, MI 49503-3262
Phone
(616) 228-9244
Fax
(616) 327-6333
NPI assigned
Mar 5, 2020
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4101006921 MI
Marriage & Family Therapist 106H00000X NU
Marriage & Family Therapist 106H00000X 4101007262 MI Primary

Addresses

Primary practice location

233 Fulton St E Ste 28
Grand Rapids, MI 49503-3262

Mailing address

2621 N Tamarack Dr
Midland, MI 48642-7887
Phone (989) 948-3503

Other practice location 1

2621 N Tamarack Dr
Midland, MI 48642-7887
Phone (989) 948-3503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4101006921MIMDMental Health Counselor
4101007262MIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1932734357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 N TAMARACK DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427887",
            "telephone_number": "989-948-3503",
            "fax_number": "616-327-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E STE 28",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033262",
            "telephone_number": "616-228-9244",
            "fax_number": "616-327-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2621 N Tamarack Dr",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486427887",
            "country_code": "US",
            "telephone_number": "989-948-3503",
            "fax_number": "616-327-6333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMALDI",
        "first_name": "ELIZABETH",
        "middle_name": "JODI",
        "credential": "LLMFT, MDIV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "4101006921",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101007262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.