Healthcare Provider Details

I. General information

NPI: 1982904363
Provider Name (Legal Business Name): PATRICIA ANN GRIFFIS LMHC, CAP,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 LORA ST
NEPTUNE BEACH FL
32266-4938
US

IV. Provider business mailing address

133 LORA ST
NEPTUNE BEACH FL
32266-4938
US

V. Phone/Fax

Practice location:
  • Phone: 904-477-4640
  • Fax:
Mailing address:
  • Phone: 904-477-4640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: