Provider Demographics
NPI:1518386838
Name:GRIFFIN, PHILIP LEWIS (LMHC)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:LEWIS
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 222ND PL SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5888
Mailing Address - Country:US
Mailing Address - Phone:425-502-0550
Mailing Address - Fax:
Practice Address - Street 1:2406 222ND PL SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5888
Practice Address - Country:US
Practice Address - Phone:425-502-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00005655OtherWA DEPARTMENT OF LICENSING
WALH00005655OtherDEPARTMENT OF LICENSING