Provider Demographics
NPI:1417283466
Name:GRIFFIN, SHANNA (MSW)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:BRADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:9 HANOVER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1312
Mailing Address - Country:US
Mailing Address - Phone:603-448-0126
Mailing Address - Fax:
Practice Address - Street 1:167 SUMMER ST
Practice Address - Street 2:SUIT 3
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1281
Practice Address - Country:US
Practice Address - Phone:603-863-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor