Healthcare Provider Details

I. General information

NPI: 1558338046
Provider Name (Legal Business Name): KATHRYN A GRIFFITHS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 01/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W MAIN ST SUITE 1
BOONTON NJ
07005-1168
US

IV. Provider business mailing address

57 HAMPTON HEIGHTS RD
LAFAYETTE NJ
07848-3812
US

V. Phone/Fax

Practice location:
  • Phone: 973-257-5666
  • Fax:
Mailing address:
  • Phone: 973-257-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04309700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: