Provider Demographics
NPI:1376358937
Name:GRIMSLEY, JOSEPH GRANGER IV (RMHCI)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GRANGER
Last Name:GRIMSLEY
Suffix:IV
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6290
Mailing Address - Country:US
Mailing Address - Phone:407-488-7262
Mailing Address - Fax:
Practice Address - Street 1:365 WEKIVA SPRINGS RD STE 231
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3690
Practice Address - Country:US
Practice Address - Phone:407-488-7262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health