MEDICARE: RYAN GRIFFUS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		MI

General Provider Information

NPI Number	:	1396278016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN GRIFFUS

Provider Business Mailing Address
First Line	:	774 S DOE TRL
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-8817
Country	:	US
Telephone Number	:	989-429-2506
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 S DOE TRL
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-8817
Country	:	US
Telephone Number	:	989-429-2506
Fax Number	:

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

Provider Enumeration Date	:	04/10/2017
Last Update Date	:	01/26/2026

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Directions to “ RYAN GRIFFUS ” Practice Location

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