Provider Demographics
NPI:1093157034
Name:GRIFFIN, FAITH ELISABETH (LCPC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ELISABETH
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3134
Mailing Address - Country:US
Mailing Address - Phone:217-994-4898
Mailing Address - Fax:
Practice Address - Street 1:2313B HOFFMAN DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2839
Practice Address - Country:US
Practice Address - Phone:217-994-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health