Provider Demographics
NPI:1225615651
Name:GRIFFITH, BONNIE GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:GAIL
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:GRIFFITH
Other - Last Name:WALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:11825 ROCK LANDING DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4236
Mailing Address - Country:US
Mailing Address - Phone:757-873-1736
Mailing Address - Fax:757-873-1028
Practice Address - Street 1:11825 ROCK LANDING DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4236
Practice Address - Country:US
Practice Address - Phone:757-873-1736
Practice Address - Fax:757-873-1028
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical