Healthcare Provider Details

I. General information

NPI: 1659914794
Provider Name (Legal Business Name): GRIFFIN AND ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 OHIO BLVD STE 116-7
TERRE HAUTE IN
47803-2239
US

IV. Provider business mailing address

2901 OHIO BLVD STE 116-7
TERRE HAUTE IN
47803-2239
US

V. Phone/Fax

Practice location:
  • Phone: 812-917-7151
  • Fax: 812-638-4110
Mailing address:
  • Phone: 812-917-7151
  • Fax: 812-638-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STARR GRIFFIN
Title or Position: OWNER/LMHC
Credential: LMHC
Phone: 812-841-0464