Active NPI
Elizabeth Jodi Grimaldi, LLMFT, MDIV
- Marriage & Family Therapist
- Grand Rapids, MI
National Provider Identifier
1932734357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4101007262
- 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, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4101006921 | MI | MD | Mental Health Counselor |
| 4101007262 | MI | MD | Marriage & 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.