MEDICARE: MR. ERROL GRIFFIN LMHC

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	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MH15881	FL

General Provider Information

NPI Number	:	1831514801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERROL GRIFFIN LMHC

Provider Business Mailing Address
First Line	:	2590 EL BETHEL CHURCH RD
Second Line	:
City	:	GRAND RIDGE
State	:	FL
Zip	:	32442-4442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2590 EL BETHEL CHURCH RD
Second Line	:
City	:	GRAND RIDGE
State	:	FL
Zip	:	32442-4442
Country	:	US
Telephone Number	:	850-557-1567
Fax Number	:

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	04/01/2024

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