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General NPI Number Information
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NPI Number | 1649654104
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Entity Type | Organization
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Legal Business Name | EMILY GRIMES, LCSW PLLC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 16511 NORTHCROSS DRIVE SUITE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-877-7503
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Fax | 980-399-5413
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Provider Business Mailing Address
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Address Line | 16511 NORTHCROSS DRIVE SUITE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-877-7503
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Fax | 980-399-5413
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MRS. EMILY C GRIMES
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Credential | MSW, LCSW
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Telephone | 704-877-7503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C007039
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License Number State | NC
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