Provider Demographics
NPI:1245612407
Name:GRIMES, KAREN (LMHC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 BOYLSTON ST
Mailing Address - Street 2:SUITE 802C
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3608
Mailing Address - Country:US
Mailing Address - Phone:617-840-3904
Mailing Address - Fax:
Practice Address - Street 1:581 BOYLSTON ST
Practice Address - Street 2:SUITE 802C
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3608
Practice Address - Country:US
Practice Address - Phone:617-840-3904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health