Healthcare Provider Details

I. General information

NPI: 1265343693
Provider Name (Legal Business Name): LATOYA GRIFFIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9417 SAINT JOE CENTER RD
FORT WAYNE IN
46835-9259
US

IV. Provider business mailing address

8303 NORWOOD CT
FORT WAYNE IN
46835-9687
US

V. Phone/Fax

Practice location:
  • Phone: 260-209-1433
  • Fax:
Mailing address:
  • Phone: 757-897-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LATOYA GRIFFIN
Title or Position: OWNER/THERAPIST
Credential: LMFT
Phone: 757-897-6331