Provider Demographics
NPI:1689096620
Name:GRIMMETT, RHONDA RICHARDSON (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:RICHARDSON
Last Name:GRIMMETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LAVON
Other - Last Name:GRIMMETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:300 W VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-5566
Mailing Address - Country:US
Mailing Address - Phone:432-263-7361
Mailing Address - Fax:432-268-5061
Practice Address - Street 1:300 W VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-5566
Practice Address - Country:US
Practice Address - Phone:432-263-7361
Practice Address - Fax:432-268-5061
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA266461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical