Provider Demographics
NPI:1508368564
Name:GRIFFIN, NINA SHAREE (CERTIFIED PEER RECOV)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:SHAREE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:CERTIFIED PEER RECOV
Other - Prefix:MISS
Other - First Name:NINA
Other - Middle Name:SHAREE
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4650 RANCH HOUSE RD UNIT 64
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4613
Mailing Address - Country:US
Mailing Address - Phone:702-219-6882
Mailing Address - Fax:
Practice Address - Street 1:4650 RANCH HOUSE RD UNIT 64
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4613
Practice Address - Country:US
Practice Address - Phone:702-219-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner