MR. Scott Randall Grim, LISW, LICDC

NPI #1306983341 in Newark, Ohio

Provider Information

NPI Number: 1306983341
Entity Type: Individual
Name: MR. Scott Randall Grim, LISW, LICDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LISW, LICDC
Enumeration Date: Jan 31, 2007
Last Updated: Feb 24, 2021

Practice Location

Address: 1445 W MAIN ST
City: Newark
State: Ohio
ZIP Code: 43055-1989
Phone: (513) 834-7063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Social Worker - Clinical — Clinical	1041C0700X
Social Worker	104100000X	Primary

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