Provider Demographics
NPI:1659063006
Name:ELM PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:ELM PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:347-806-1348
Mailing Address - Street 1:5 WATERBURY RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1713
Mailing Address - Country:US
Mailing Address - Phone:347-806-1348
Mailing Address - Fax:
Practice Address - Street 1:333 BLOOMFIELD AVE STE 201-3
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:347-806-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty