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NPI Code Detail

MEDICARE: DESIREE GRIFFIN, M.S., LMHC

MEDICARE: DESIREE GRIFFIN, M.S., LMHC
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
1101YM0800XMental Health CounselorMH4968FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111850334OTHERFLCAQH
2Z011HOTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326405184
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESIREE GRIFFIN, M.S., LMHC
Provider Business Mailing Address
First Line : 4609 US HIGHWAY 17
Second Line : SUITE 1
City : FLEMING ISLAND
State : FL
Zip : 32003-4818
Country : US
Telephone Number : 904-759-7462
Fax Number : 904-269-0021
Provider Business Practice Location Address
First Line : 4609 US HIGHWAY 17
Second Line : SUITE 1
City : FLEMING ISLAND
State : FL
Zip : 32003-4818
Country : US
Telephone Number : 904-759-7462
Fax Number : 904-269-0021
Authorized Official
Title or Position : LMHC
Name : MS. DESIREE ANN GRIFFIN
Credential : M.S.
Telephone Number : 904-759-7462
Provider Enumeration Date : 01/25/2016
Last Update Date : 01/26/2016

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