Provider Demographics
NPI:1679269534
Name:GRIFFIN, VERONICA YVONNE (VIRGINIA, ALABAMA)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:YVONNE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:VIRGINIA, ALABAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WESTWOOD OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5109
Mailing Address - Country:US
Mailing Address - Phone:757-560-7245
Mailing Address - Fax:
Practice Address - Street 1:415 WESTWOOD OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5109
Practice Address - Country:US
Practice Address - Phone:540-736-7501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
AL4854G104100000X
VA09030003324104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health