Healthcare Provider Details

I. General information

NPI: 1144270521
Provider Name (Legal Business Name): KAREN ROGERS GRIFFIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 HOPMEADOW ST
SIMSBURY CT
06070
US

IV. Provider business mailing address

PO BOX 163
SIMSBURY CT
06070-0163
US

V. Phone/Fax

Practice location:
  • Phone: 860-670-3088
  • Fax: 845-230-6226
Mailing address:
  • Phone: 860-670-3088
  • Fax: 845-230-6226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004650
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number004650
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: