MEDICARE: JANICE LEAH GRIFFIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW14674	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SW14674	OTHER	FL	LICENSED CLINICAL SOCIAL WORKER

General Provider Information

NPI Number	:	1083139315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE LEAH GRIFFIN LCSW

Provider Business Mailing Address
First Line	:	849 BLUE RIDGE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-7618
Country	:	US
Telephone Number	:	772-971-3566
Fax Number	:	561-209-2771

Provider Business Practice Location Address
First Line	:	401 N ROSEMARY AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-4133
Country	:	US
Telephone Number	:	772-971-3566
Fax Number	:	561-209-2771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	07/12/2019

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