Provider Demographics
NPI:1356440994
Name:GRIFFIOEN, STEVEN CRAIG (PSYD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CRAIG
Last Name:GRIFFIOEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 KINNEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-4509
Mailing Address - Country:US
Mailing Address - Phone:616-735-5491
Mailing Address - Fax:
Practice Address - Street 1:468 KINNEY AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-4509
Practice Address - Country:US
Practice Address - Phone:616-735-5491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical