Healthcare Provider Details

I. General information

NPI: 1841117488
Provider Name (Legal Business Name): TERRENCE GRIFFIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 DUKE ST STE 106
PRINCE FREDERICK MD
20678-6128
US

IV. Provider business mailing address

4612 QUEENS GROVE ST
WHITE PLAINS MD
20695-3457
US

V. Phone/Fax

Practice location:
  • Phone: 703-597-9267
  • Fax:
Mailing address:
  • Phone: 703-597-9267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: