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General NPI Number Information
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NPI Number | 1083067672
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Entity Type | Organization
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Legal Business Name | GRIFFIN COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 435 BUCKLAND RD BRANDYWINE
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-3720
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Country | US
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Telephone | 860-709-0697
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Fax | 860-788-4630
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Provider Business Mailing Address
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Address Line | 5 DAISY LN
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City | ELLINGTON
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State | CT
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Zip | 06029-3239
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Country | US
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Telephone | 860-709-0697
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Fax | 860-788-4630
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER J GRIFFIN
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Credential | L.P.C.
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Telephone | 857-636-0470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 002865
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License Number State | CT
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