=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629706189
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAITLYNN GRIFFIN LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2022
-----------------------------------------------------
Last Update Date | 09/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4144 N CENTRAL EXPY STE 850
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75204-3226
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-489-9464
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1400 ANDREWS PKWY APT 3159
-----------------------------------------------------
City | ALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75002-2976
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-343-6316
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 82396
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------