Healthcare Provider Details

I. General information

NPI: 1952884595
Provider Name (Legal Business Name): JANICE T GRIFFIN LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 E DE SOTO ST
PENSACOLA FL
32501-3337
US

IV. Provider business mailing address

1221 E DE SOTO ST
PENSACOLA FL
32501-3337
US

V. Phone/Fax

Practice location:
  • Phone: 850-437-9997
  • Fax: 850-439-2122
Mailing address:
  • Phone: 850-437-9997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JANICE T GRIFFIN
Title or Position: OWNER
Credential:
Phone: 850-449-2847