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General NPI Number Information
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NPI Number | 1770029381
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Entity Type | Individual
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Provider Name | KEISHA MCDONALD-GRIFFIN LPC
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Gender | Female
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 401 HALL ST SW STE 112J
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-6501
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Country | US
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Telephone | 616-719-7164
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Fax |
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Provider Business Mailing Address
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Address Line | 401 HALL ST SW STE 112J
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-6501
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Country | US
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Telephone | 616-719-7164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401018534
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License Number State | MI
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