Provider Demographics
NPI:1679333439
Name:GRIFFIN, CASEY L (PSYD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:L
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9216
Mailing Address - Country:US
Mailing Address - Phone:315-720-0552
Mailing Address - Fax:
Practice Address - Street 1:719 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2695
Practice Address - Country:US
Practice Address - Phone:315-464-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist