Provider Demographics
NPI:1225892193
Name:DR. JULIE GRIFFIN LLC
Entity Type:Organization
Organization Name:DR. JULIE GRIFFIN LLC
Other - Org Name:DR. JULIE GRIFFIN LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LMHC
Authorized Official - Phone:502-457-3969
Mailing Address - Street 1:4323 SILVER GLADE TRL # US
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-1785
Mailing Address - Country:US
Mailing Address - Phone:502-457-3969
Mailing Address - Fax:812-748-0181
Practice Address - Street 1:4323 SILVER GLADE TRL # US
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-1785
Practice Address - Country:US
Practice Address - Phone:502-457-3969
Practice Address - Fax:812-748-0181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)