Provider Demographics
NPI:1407018807
Name:GRIFFIN, SYRALJA P (LPC)
Entity Type:Individual
Prefix:
First Name:SYRALJA
Middle Name:P
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPC
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 681
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-0681
Mailing Address - Country:US
Mailing Address - Phone:985-520-0567
Mailing Address - Fax:985-467-4337
Practice Address - Street 1:215 E CHARLES ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3305
Practice Address - Country:US
Practice Address - Phone:985-520-0567
Practice Address - Fax:985-467-4337
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional