Provider Demographics
NPI:1578691150
Name:GRIFFIN, DANA ANN (EDD, LPC, CPCS)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:EDD, LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 ROYAL DR SW
Mailing Address - Street 2:SUITE D
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5925
Mailing Address - Country:US
Mailing Address - Phone:678-658-0645
Mailing Address - Fax:
Practice Address - Street 1:1226 ROYAL DR SW
Practice Address - Street 2:SUITE D
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5925
Practice Address - Country:US
Practice Address - Phone:678-658-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001292101YP2500X
GALPC005372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA512392223CMedicaid