DR. LARRY L. GRIMM (NPI# 1396966453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396966453 |
| Entity Type | Individual |
| Full Name | DR. LARRY L. GRIMM |
| Credential | ED.D. |
| Practice Address |
222 S. Summit Ave., Ste. 1 Prescott AZ 86303-3780 |
| Mailing Address |
P.o. Box 11255 Prescott AZ 86304-1255 |
| Practice Telephone | 9284430428 |
| Practice Fax Number | 9284430454 |
| Mailing Telephone | 9284430428 |
| Mailing Fax Number | 9284430454 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1195 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
222 S. SUMMIT AVE., STE. 1 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86303-3780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447598 | Jacqueline Schlosser | Respite Care | 237 S. Washington Ave., Prescott, AZ 86303 | 2018-08-18 |
| 1033699210 | Anna Rachel Seno | Psychologist | 300 S Granite Street, Prescott, AZ 86303 | 2018-08-17 |
| 1871944322 | Jessie Deverna | Counselor | 450 W Goodwin St Suite 103b, Prescott, AZ 86303 | 2016-06-27 |
| 1154782845 | Walmart | Pharmacy | 1120 N. Opal Dr., Prescott, AZ 86303 | 2016-03-09 |
| 1710377650 | Compass Recovery Center LLC | Clinic/Center | 711 S. Granite St, Prescott, AZ 86303 | 2015-01-30 |
| 1154727527 | Anne Gurley Klever | Pharmacist | 500 Arizona 89, Prescott, AZ 86303 | 2014-11-13 |
| 1295131860 | Kathi Sabot | Registered Nurse | 146 S. Granite Street, Prescott Unified School District, Prescott, AZ 86303 | 2014-11-10 |
| 1457697989 | Kim K. Mcintyre | Counselor | 505 S. Cortez St., Prescott, AZ 86303 | 2013-01-03 |
| 1578885257 | Wesley Carl Kitchens | Counselor | 315 W Goodwin St, Prescott, AZ 86303 | 2010-02-22 |
| 1588805907 | Jacob Lee Bean | Physical Therapist | 6820 El Dorado Dr, Prescott, AZ 86303 | 2009-03-14 |
| Find all providers in zip 86303 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202594 | Olugus Family Care | Psychologist | 44077 W. Palmen Dr., Maricopa, AZ 85138 | 2020-10-15 |
| 1972029205 | Prism Learning and Development, Pllc | Psychologist | 7157 E Rancho Vista Dr Ste 7147b24, Scottsdale, AZ 85251-1494 | 2017-08-18 |
| 1477928471 | Erin Testa | Psychologist | 7600 N 16th St Ste 218, Phoenix, AZ 85020 | 2015-12-02 |
| 1811360316 | Redemption Psychiatry LLC | Psychologist | 2730 S Val Vista Dr Ste 137, Gilbert, AZ 85295-1681 | 2015-11-05 |
| 1447582937 | Shefali Gandhi, Psy.d., P.l.l.c. | Psychologist | 7120 E 6th Ave, Suite 20, Scottsdale, AZ 85251-3228 | 2010-02-08 |
| 1306077979 | Sue R Lerner | Psychologist | 6773 E Gelding Dr, Scottsdale, AZ 85254-3494 | 2009-07-30 |
| 1417137274 | Cathy Lynn Bissett | Psychologist | 24654 N Lake Pleasant Pkwy Ste 103-497, Peoria, AZ 85383-1359 | 2007-11-09 |
| 1982890588 | Erin Keely Lanphier | Psychologist | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2007-09-18 |
| 1801919840 | Tyra Maria Ripley | Psychologist | 3120 W Cholla St, Phoenix, AZ 85029-4113 | 2007-04-06 |
| 1154475648 | Kathleen Campbell | Psychologist | 4550 E 5th St, Tucson, AZ 85711-7004 | 2007-01-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.