Provider Demographics
NPI:1609148972
Name:GRIFFIN, KELLY SHENEA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:SHENEA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 WANDERING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8011
Mailing Address - Country:US
Mailing Address - Phone:757-344-1487
Mailing Address - Fax:
Practice Address - Street 1:6508 WANDERING CREEK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8011
Practice Address - Country:US
Practice Address - Phone:757-344-1487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical