Provider Demographics
NPI:1215229323
Name:GRIFFIN, LINDA JO (LISW-CP, CAC-II)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JO
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LISW-CP, CAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 TIMBERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-9290
Mailing Address - Country:US
Mailing Address - Phone:864-433-1180
Mailing Address - Fax:
Practice Address - Street 1:161 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2819
Practice Address - Country:US
Practice Address - Phone:864-244-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC65991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical