Provider Demographics
NPI:1083139315
Name:GRIFFIN, JANICE LEAH (LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LEAH
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:LEAH
Other - Last Name:DUVAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:849 BLUE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7618
Mailing Address - Country:US
Mailing Address - Phone:772-971-3566
Mailing Address - Fax:561-209-2771
Practice Address - Street 1:401 N ROSEMARY AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4133
Practice Address - Country:US
Practice Address - Phone:772-971-3566
Practice Address - Fax:561-209-2771
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW14674OtherLICENSED CLINICAL SOCIAL WORKER