| Doctor Name: | MRS. NICOLE ELENA GRIMM |
| NPI Number: | 1396070389 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.P.C. |
| License Number: | 180-006750 |
| Business Practice Address: | 88 South Main Suite 2 Alternatives Counseling Inc. Glen Carbon, IL - 62034 |
| Business Phone Number: | 6182888085 |
| Business Fax Number: | 6182888959 |
| Mailing Address: | P.o. Box 639, 88 South Main Suite 2 GLEN CARBON |
| State: | IL |
| Postal Code: | 62034 |
| Phone Number: | 6182888085 |
| Fax Number: | 6182888959 |
| NPI Enumeration Date: | 10/08/2009 |
| NPI Last Update Date: | 10/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 180-006750 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |