Provider Demographics
NPI:1578697744
Name:GRIFFIN, SARA SUZANNE (LCPC, LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SUZANNE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 S DORT HWY
Mailing Address - Street 2:SUITE 44
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2093
Mailing Address - Country:US
Mailing Address - Phone:810-744-3300
Mailing Address - Fax:810-744-1090
Practice Address - Street 1:3600 S DORT HWY
Practice Address - Street 2:SUITE 44
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2093
Practice Address - Country:US
Practice Address - Phone:810-744-3300
Practice Address - Fax:810-744-1090
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005632101YP2500X
MI6401012931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional