Provider Demographics
NPI:1629122056
Name:GRIFFITH, DAVID J (MS, LCADC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MS, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50-08 W. LINDSLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009
Mailing Address - Country:US
Mailing Address - Phone:201-567-0500
Mailing Address - Fax:201-567-9335
Practice Address - Street 1:93 W PALISADE AVE
Practice Address - Street 2:VANTAGE HEALTH SYSTEM
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2611
Practice Address - Country:US
Practice Address - Phone:201-567-0500
Practice Address - Fax:201-567-4348
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00013000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)