Provider Demographics
NPI:1689086225
Name:GRIFFITH, MICHELE T (LSCSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:T
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-1367
Mailing Address - Country:US
Mailing Address - Phone:620-344-0472
Mailing Address - Fax:
Practice Address - Street 1:509 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-1367
Practice Address - Country:US
Practice Address - Phone:620-344-0472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS50301041C0700X
AZLCSW-6303T1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical