Provider Demographics
NPI:1215557749
Name:DONNA GRIFFIN LMFT
Entity Type:Organization
Organization Name:DONNA GRIFFIN LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-522-4111
Mailing Address - Street 1:1 FLORIDA PARK DR S STE 322
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3802
Mailing Address - Country:US
Mailing Address - Phone:760-522-4111
Mailing Address - Fax:386-246-2738
Practice Address - Street 1:1 FLORIDA PARK DR S STE 322
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3802
Practice Address - Country:US
Practice Address - Phone:760-522-4111
Practice Address - Fax:386-246-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)