Healthcare Provider Details

I. General information

NPI: 1447113964
Provider Name (Legal Business Name): DIANA GRIFFITH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 ORCHID AVE
WINTER PARK FL
32789-5649
US

IV. Provider business mailing address

1505 ORCHID AVE
WINTER PARK FL
32789-5649
US

V. Phone/Fax

Practice location:
  • Phone: 407-644-4692
  • Fax:
Mailing address:
  • Phone: 407-644-6492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSW25815
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: