Active NPI
Nichole Grimes, MA, LPC, LMHC
- Counselor
- Roswell, GA
National Provider Identifier
1962991513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC012800
- Practice address
- 1007 Mansell Rd Ste A205
Roswell, GA 30076-5019 - Phone
- (678) 756-2232
- NPI assigned
- May 8, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC012800 | GA | |
| Counselor | 101Y00000X | MH13235 | FL | |
| Counselor | 101Y00000X | 3676 | AL | |
| Counselor | 101Y00000X | LPC012800 | GA | Primary |
Addresses
Primary practice location
1007 Mansell Rd Ste A205
Roswell, GA 30076-5019
Mailing address
1007 Mansell Rd Ste A205
Roswell, GA 30076-5019
Phone (678) 756-2232
Other practice location 1
300 Office Park Dr Ste 220
Mountain Brk, AL 35223-2473
Phone (205) 538-3099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 27, 2025 through Sep 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3676 | AL | MD | Counselor |
| MH13235 | FL | MD | Counselor |
| LPC012800 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inner Atlas Counseling, LLC | Counselor | Current | Accepting new patients |
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.
-
- Counselor
- Decatur, GA
- NPI 1295485597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664496000000",
"number": "1962991513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 MANSELL RD STE A205",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765019",
"telephone_number": "678-756-2232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 MANSELL RD STE A205",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765019",
"telephone_number": "678-756-2232"
}
],
"practiceLocations": [
{
"address_1": "300 Office Park Dr Ste 220",
"address_purpose": "LOCATION",
"city": "Mountain Brk",
"state": "AL",
"postal_code": "352232473",
"country_code": "US",
"telephone_number": "205-538-3099",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIMES",
"first_name": "NICHOLE",
"credential": "MA, LPC, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2022-09-30",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC012800",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "MH13235",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "3676",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC012800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.