Healthcare Provider Details

I. General information

NPI: 1720525710
Provider Name (Legal Business Name): SARAH C GRIFFIN-ORTIZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4835 POND RIDGE DR
RIVERVIEW FL
33578-2106
US

IV. Provider business mailing address

4835 POND RIDGE DR
RIVERVIEW FL
33578-2106
US

V. Phone/Fax

Practice location:
  • Phone: 813-600-0353
  • Fax:
Mailing address:
  • Phone: 813-600-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16514
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH16514
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: