Provider Demographics
NPI:1972740561
Name:GRIMONE, SHERRI A (LISW-S)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:A
Last Name:GRIMONE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 SOUTH LIMESTONE STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505
Mailing Address - Country:US
Mailing Address - Phone:937-324-1111
Mailing Address - Fax:937-322-3368
Practice Address - Street 1:347 SCIOTO ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2129
Practice Address - Country:US
Practice Address - Phone:888-390-3800
Practice Address - Fax:937-390-3804
Is Sole Proprietor?:No
Enumeration Date:2009-01-19
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00060731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical