Provider Demographics
NPI:1407962038
Name:GRIFFIN, WILLIAM M (RNCS PC APRN BC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:GRIFFIN
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Gender:M
Credentials:RNCS PC APRN BC
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Mailing Address - Street 1:31 LAKE ST
Mailing Address - Street 2:NORTH CENTRAL HUMAN SERVICES
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3879
Mailing Address - Country:US
Mailing Address - Phone:978-632-9400
Mailing Address - Fax:978-632-9410
Practice Address - Street 1:31 LAKE ST
Practice Address - Street 2:NORTH CENTRAL HUMAN SERVICES
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3879
Practice Address - Country:US
Practice Address - Phone:978-632-9400
Practice Address - Fax:978-632-9410
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA124435101YA0400X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
414316OtherTUFTS
MA1306421Medicaid
MA1308785OtherMCD MH
MA2220002001OtherBCBS SA
MA2220002001OtherBCBS SA
NS821S4Medicare UPIN