Provider Demographics
NPI:1295597698
Name:GRIMES, HAROLD (NCPSS, CPSS (CT))
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:GRIMES
Suffix:
Gender:M
Credentials:NCPSS, CPSS (CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WADSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-7108
Mailing Address - Country:US
Mailing Address - Phone:860-692-1023
Mailing Address - Fax:860-724-2539
Practice Address - Street 1:45 WADSWORTH ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-7108
Practice Address - Country:US
Practice Address - Phone:806-962-1023
Practice Address - Fax:860-724-1023
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1048175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist