MARY LISA GRIMMER – Mental Health Counselor, NPI 1629708243

MARY LISA GRIMMER is a healthcare provider. based in Fort myers, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. MH11345 (FL). The NPI Number for MARY LISA GRIMMER is 1629708243

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
MARY LISA GRIMMER
NPI
1629708243
Phone
(239) 410-7559
Address
7235 MAIDA LN APT 5C
Enumeration Date
15 June 2022
Last Update Date
15 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2394271833
Graduation Year
2006 (20 years ago)
PAC ID
4688194939
Group Practice PAC ID
6709310733
Professional Enrollment ID
I20250218000657
Address ID
FL341093926NA3443XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for MARY LISA GRIMMER

  • 7235 MAIDA LN APT 5C

    FORT MYERS, FL 339084203

    Phone: (239) 410-7559

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250218000657IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33908)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709310733View full group profile
NameSpecialtyState
Mental Health CounselorFL
Marriage And Family TherapistFL
Clinical Social WorkerFL
Mental Health CounselorFL

Reviews

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Frequently asked questions

Where can patients find MARY LISA GRIMMER's NPI?
You can confirm MARY LISA GRIMMER with NPI 1629708243; it appears in the national provider directory.
Is MARY LISA GRIMMER active in the national directory?
MARY LISA GRIMMER's public NPI profile is in an active state.
What field does MARY LISA GRIMMER work in?
You can think of MARY LISA GRIMMER as practicing within Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for MARY LISA GRIMMER?
The page summarizes Fort Myers, Florida for MARY LISA GRIMMER; expand the address list for detail.
How can I contact MARY LISA GRIMMER?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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