Provider Demographics
NPI:1619114022
Name:GRIFFITH, JASYN ANASTASIA (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JASYN
Middle Name:ANASTASIA
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304C COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2212
Mailing Address - Country:US
Mailing Address - Phone:252-637-4673
Mailing Address - Fax:
Practice Address - Street 1:1304C COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2212
Practice Address - Country:US
Practice Address - Phone:252-637-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105231Medicaid