Provider Demographics
NPI:1235215278
Name:GRIMES, CHRISTY (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20509 S STATE RT J
Mailing Address - Street 2:PO BOX 447
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-0447
Mailing Address - Country:US
Mailing Address - Phone:816-779-5173
Mailing Address - Fax:816-758-5112
Practice Address - Street 1:20509 SOUTH STATE ROUTE J
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-0447
Practice Address - Country:US
Practice Address - Phone:816-779-5173
Practice Address - Fax:816-758-5112
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060002501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical