Healthcare Provider Details

I. General information

NPI: 1659227254
Provider Name (Legal Business Name): KATRINA CEE GRIFFIS CAUBLE LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 CROSS TRAIL DR REAR
CHARLOTTE NC
28204-2057
US

IV. Provider business mailing address

704 CROSS TRAIL DR
CHARLOTTE NC
28204-2057
US

V. Phone/Fax

Practice location:
  • Phone: 704-756-0405
  • Fax:
Mailing address:
  • Phone: 704-756-0405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10259
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: