Provider Demographics
NPI:1033862735
Name:GRIMES, TONEY PICKROM (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:TONEY
Middle Name:PICKROM
Last Name:GRIMES
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 RILEY RD
Mailing Address - Street 2:
Mailing Address - City:PIONEER
Mailing Address - State:LA
Mailing Address - Zip Code:71266-8992
Mailing Address - Country:US
Mailing Address - Phone:318-509-9873
Mailing Address - Fax:
Practice Address - Street 1:339 RILEY RD
Practice Address - Street 2:
Practice Address - City:PIONEER
Practice Address - State:LA
Practice Address - Zip Code:71266-8992
Practice Address - Country:US
Practice Address - Phone:318-509-9873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health