Healthcare Provider Details

I. General information

NPI: 1952214082
Provider Name (Legal Business Name): JEFFREY GRIFFITH LMHCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 N EMERSON AVE
GREENWOOD IN
46143-6449
US

IV. Provider business mailing address

48 N EMERSON AVE
GREENWOOD IN
46143-6449
US

V. Phone/Fax

Practice location:
  • Phone: 317-881-0409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003514A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: