Basic Information
| Provider Information | |||||||||
| NPI: | 1972740561 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIMONE | ||||||||
| FirstName: | SHERRI | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LISW-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 651 SOUTH LIMESTONE STREET | ||||||||
| Address2: | SUITE C | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373241111 | ||||||||
| FaxNumber: | 9373223368 | ||||||||
| Practice Location | |||||||||
| Address1: | 347 SCIOTO ST | ||||||||
| Address2: | |||||||||
| City: | URBANA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430782129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883903800 | ||||||||
| FaxNumber: | 9373903804 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2009 | ||||||||
| LastUpdateDate: | 07/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I 0006073 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.