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General NPI Number Information
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NPI Number | 1326405184
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Entity Type | Organization
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Legal Business Name | DESIREE GRIFFIN, M.S., LMHC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 4609 US HIGHWAY 17 SUITE 1
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4818
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Country | US
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Telephone | 904-759-7462
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Fax | 904-269-0021
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Provider Business Mailing Address
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Address Line | 4609 US HIGHWAY 17 SUITE 1
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4818
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Country | US
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Telephone | 904-759-7462
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Fax | 904-269-0021
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Authorized Official
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Title or Position | LMHC
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Name | MS. DESIREE ANN GRIFFIN
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Credential | M.S.
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Telephone | 904-759-7462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH4968
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License Number State | FL
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