Provider Demographics
NPI:1376796136
Name:GRIFFIN, GALE (PCC)
Entity Type:Individual
Prefix:MS
First Name:GALE
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181461
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-7461
Mailing Address - Country:US
Mailing Address - Phone:216-322-5418
Mailing Address - Fax:
Practice Address - Street 1:1554 E 193RD ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1387
Practice Address - Country:US
Practice Address - Phone:216-322-5418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0007434101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor