Healthcare Provider Details

I. General information

NPI: 1669384715
Provider Name (Legal Business Name): JULIE M GRIFFITH ED.S, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7536 FAIRFIELD LAKES DR
POWELL OH
43065-7879
US

IV. Provider business mailing address

7536 FAIRFIELD LAKES DR
POWELL OH
43065-7879
US

V. Phone/Fax

Practice location:
  • Phone: 440-376-6718
  • Fax:
Mailing address:
  • Phone: 440-376-6718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSP00779
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP02480
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: