Healthcare Provider Details

I. General information

NPI: 1720764525
Provider Name (Legal Business Name): KAITLYN ELIZABETH GRIFFITHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 US-395 SUITE 100
GARDNERVILLE NV
89410
US

IV. Provider business mailing address

PO BOX 1509
MINDEN NV
89423
US

V. Phone/Fax

Practice location:
  • Phone: 775-687-2162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13162-C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7718-M
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: