MALLORY GRIMSTE LLC (NPI# 1417444910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417444910 |
| Entity Type | Organization |
| Organization Name | MALLORY GRIMSTE LLC |
| Other Organization Name | MALLORY GRIMSTE, LCSW |
| Practice Address |
30 Hazel Ter Ste 12 Woodbridge CT 06525-2240 |
| Practice Telephone | 2032288971 |
| Practice Fax Number | 2034298628 |
| Mailing Telephone | 2032288971 |
| Mailing Fax Number | 2034298628 |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |
| Authorized Official Name | MALLORY GRIMSTE (OWNER) |
| Authorized Official Telephone | 2032288971 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Mallory Grimste, LCSW | Doing Business As Name - Organization |
| Street Address |
30 HAZEL TER STE 12 |
| City | WOODBRIDGE |
| State | CT |
| Zip Code | 06525-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649838822 | Arcadian Counseling, LLC | Counselor | 176 Amity Rd # 283, Woodbridge, CT 06525 | 2019-06-03 |
| 1538604566 | Susan G Israel | Psychiatry & Neurology | 18 Carriage Hill Road, Woodbridge, CT 06525 | 2016-12-29 |
| 1417409947 | Personal Care Training LLC | Home Health | 30 Hazel Terace #7, Woodbridge, CT 06525 | 2016-11-01 |
| 1538506324 | James A Killian | Counselor | 1 Bradley Rd Ste 106, Woodbridge, CT 06525 | 2013-06-03 |
| 1154666063 | Julie M Charron | Physical Therapy Assistant | 5 Spring Valley Rd, Woodbridge, CT 06525 | 2012-12-04 |
| 1780931022 | Edward David Martino | Dentist | 1674 Litchfield Turnpike, Woodbridge, CT 06525 | 2012-08-06 |
| 1972864627 | Sandra Boltax-stern, Md, PC | Psychiatry & Neurology | 78 Ansonia Road, Woodbridge, CT 06525 | 2012-05-30 |
| 1629383906 | Innovative Healthcare | Exclusive Provider Organization | 555 Amity Rd., Woodbridge, CT 06525 | 2010-08-11 |
| 1437300225 | Carl B. Lundborg | Orthopaedic Surgery | 4 Fox Hill Rd, Woodbridge, CT 06525 | 2008-10-10 |
| 1033366067 | Richard Eubanks Fearon | Internal Medicine | 20 Brook Rd, Woodbridge, CT 06525 | 2008-08-21 |
| Find all providers in zip 06525 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568518 | Ruth Ilboudo | Social Worker | 15732 John Diskin Cir, Woodbridge, VA 22191-6550 | 2020-11-05 |
| 1801409123 | Angel Bartlett | Social Worker | 2357 Brookmoor Ln, Woodbridge, VA 22191-4083 | 2020-08-26 |
| 1306308234 | Emily Manza | Social Worker | 16012 Indus Dr, Woodbridge, VA 22191-4336 | 2019-04-01 |
| 1053885707 | Shatiera Monique Amankrah | Social Worker | 3733 Hetten Ln, Woodbridge, VA 22193-1048 | 2019-01-16 |
| 1922576099 | Paula Dorman | Social Worker | 4001 Prince William Pkwy Ste 300, Woodbridge, VA 22192-7667 | 2018-11-07 |
| 1003315391 | Sage Community Counseling LLC | Social Worker | 2239b Tacketts Mill Dr, Woodbridge, VA 22192-3026 | 2018-02-02 |
| 1568902765 | Tabitha Mann | Social Worker | 12191 Cardamom Dr, Woodbridge, VA 22192-1448 | 2017-03-07 |
| 1184169765 | Mahogany Lacour | Social Worker | 4197 Windflower Ct, Woodbridge, VA 22193-5100 | 2017-01-05 |
| 1932655354 | Kayla Marie Lucas | Social Worker | 1 Bradley Rd Ste 404405, Woodbridge, CT 06525-2285 | 2016-08-26 |
| 1942663984 | Tiffany Sutton | Social Worker | 13190 Centerpointe Way Ste 101, Woodbridge, VA 22193-5286 | 2016-03-29 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 06525 |
Please comment or provide details below to improve the information on MALLORY GRIMSTE LLC.
| 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.