Provider Demographics
NPI:1639390677
Name:GRIFFIN, MARCIE ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:ANN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MARCIE
Other - Middle Name:ANN
Other - Last Name:KEANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107
Mailing Address - Country:US
Mailing Address - Phone:626-351-0056
Mailing Address - Fax:626-351-3286
Practice Address - Street 1:10605 BALBOA BLVD
Practice Address - Street 2:SUITE #330
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344
Practice Address - Country:US
Practice Address - Phone:818-832-7243
Practice Address - Fax:818-832-7213
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS233041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical