Provider Demographics
NPI:1710395223
Name:GRIMES, RHONDA (LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5830
Mailing Address - Country:US
Mailing Address - Phone:904-343-1304
Mailing Address - Fax:
Practice Address - Street 1:4375 US HIGHWAY 17
Practice Address - Street 2:SUITE 103
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4832
Practice Address - Country:US
Practice Address - Phone:904-269-0886
Practice Address - Fax:904-269-0499
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health