Provider Demographics
NPI:1306358072
Name:GRIFFIN, CHRISTOPHER DWAYNE (CDCA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DWAYNE
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22250 EUCLID AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1602
Mailing Address - Country:US
Mailing Address - Phone:216-624-0402
Mailing Address - Fax:
Practice Address - Street 1:1905 E 89TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2007
Practice Address - Country:US
Practice Address - Phone:216-231-3772
Practice Address - Fax:216-231-5040
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH120606101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)