MR. CLINTON LLOYD GRIMES BS NPI 1073781589

NPI Information

NPI: 1073781589
Provider Name: MR. CLINTON LLOYD GRIMES, BS
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
369026 US HIGHWAY 62
BOLEY, OK
ZIP 74829
Phone: (918) 667-3367
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MR. Clinton Lloyd Grimes, BS is a peer specialist in Boley, OK. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MR. Clinton Lloyd Grimes, BS NPI is 1073781589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

369026 US HIGHWAY 62
BOLEY, OK
ZIP 74829
Phone: (918) 667-3367

The enumeration date for this NPI number is 2/19/2008 and was last updated on 8/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100685660A	MEDICAID	OKLAHOMA
2	100685660D	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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