Provider Demographics
NPI:1700055480
Name:CHERYL GRIFFIN, INC.
Entity Type:Organization
Organization Name:CHERYL GRIFFIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-754-3258
Mailing Address - Street 1:8820 LADUE RD
Mailing Address - Street 2:THIRD FLOOR, STE. 317
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2079
Mailing Address - Country:US
Mailing Address - Phone:314-754-3258
Mailing Address - Fax:
Practice Address - Street 1:8820 LADUE RD
Practice Address - Street 2:THIRD FLOOR, STE. 317
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2079
Practice Address - Country:US
Practice Address - Phone:314-754-3258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW004527102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty