Healthcare Provider Details

I. General information

NPI: 1487928032
Provider Name (Legal Business Name): HEATHER TAYLOR GRIFFITH L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 S MAIN ST STE 9
DAVIDSON NC
28036-7031
US

IV. Provider business mailing address

442 S MAIN ST STE 9
DAVIDSON NC
28036-7031
US

V. Phone/Fax

Practice location:
  • Phone: 804-690-7975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5166
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC016978
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: