Provider Demographics
NPI:1225793052
Name:GRIMES, COLEIA SHAQUILLE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:COLEIA
Middle Name:SHAQUILLE
Last Name:GRIMES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12027 AMBER RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-3908
Mailing Address - Country:US
Mailing Address - Phone:202-780-9689
Mailing Address - Fax:
Practice Address - Street 1:12027 AMBER RIDGE CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-3908
Practice Address - Country:US
Practice Address - Phone:202-780-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-06
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24972104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker