Healthcare Provider Details

I. General information

NPI: 1063139806
Provider Name (Legal Business Name): RHIANNON BAZEMORE GRIGGS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE A
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE A
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 571-463-5140
  • Fax:
Mailing address:
  • Phone: 571-463-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH21319
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701014024
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: