Provider Demographics
NPI:1144379132
Name:GRIFFITH, MICHAEL ROY (MFT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ROY
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:ROY
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:870 MARKET ST
Mailing Address - Street 2:#1045
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3099
Mailing Address - Country:US
Mailing Address - Phone:415-546-6548
Mailing Address - Fax:415-824-0748
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:STE 1045
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3099
Practice Address - Country:US
Practice Address - Phone:415-546-6548
Practice Address - Fax:415-824-0748
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28859106H00000X
CA20867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No122300000XDental ProvidersDentist