MEDICARE: MICHELL L GRIFFITH PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39001480A	IN
2	103T00000X	Psychologist	20042441A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1194703983	OTHER		MILITARY

General Provider Information

NPI Number	:	1194703983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELL L GRIFFITH PSY.D

Provider Business Mailing Address
First Line	:	36065 SANTA FE AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:	254-553-6655
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 MEDICAL CENTER ROAD
Second Line	:
City	:	FT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-553-6655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	11/07/2025

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